Provider Demographics
NPI:1215070933
Name:LANG, STEPHANY NAMISNAK (ATC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANY
Middle Name:NAMISNAK
Last Name:LANG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:STEPHANY
Other - Middle Name:MARIE
Other - Last Name:NAMISNAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:2331 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-2517
Mailing Address - Country:US
Mailing Address - Phone:412-487-9084
Mailing Address - Fax:
Practice Address - Street 1:3200 S WATER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2307
Practice Address - Country:US
Practice Address - Phone:412-432-3770
Practice Address - Fax:412-432-3774
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0037052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
PART003705OtherPA STATE LICENSE