Joellen Lange

NPI #1073028403 in Bohemia, New York

Provider Information

NPI Number
1073028403
Entity Type
Individual
Name
Joellen Lange
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist
Enumeration Date
Dec 7, 2017
Last Updated
Dec 7, 2017

Practice Location

Address
539 WALNUT AVE
ZIP Code
11716-4906
Phone
(631) 987-5175

Specialties & Taxonomy Codes

Specialty
Specialist

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