Provider Demographics
NPI:1447547682
Name:LANGER, NATHANIEL BLAKESLEE (MD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:BLAKESLEE
Last Name:LANGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:177 FORT WASHINGTON AVENUE
Mailing Address - Street 2:MHB 7GN-435
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-2860
Mailing Address - Fax:917-591-8894
Practice Address - Street 1:55 FRUIT STREET
Practice Address - Street 2:COX 630
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-08
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH21457208G00000X
MA278326208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3117525Medicaid