Provider Demographics
NPI:1366785818
Name:LANG, RYAN DEVON (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DEVON
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 RAYMOND BLVD APT 21H
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-4115
Mailing Address - Country:US
Mailing Address - Phone:256-682-8515
Mailing Address - Fax:
Practice Address - Street 1:508 CARNEGIE CTR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6259
Practice Address - Country:US
Practice Address - Phone:256-682-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD81234207R00000X
NJ25MA109583002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine