Provider Demographics
NPI:1699760496
Name:LANG, ELVIRA V (MD)
Entity type:Individual
Prefix:
First Name:ELVIRA
Middle Name:V
Last Name:LANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:157 IVY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3906
Mailing Address - Country:US
Mailing Address - Phone:617-734-9087
Mailing Address - Fax:617-734-9087
Practice Address - Street 1:157 IVY ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3906
Practice Address - Country:US
Practice Address - Phone:617-734-9087
Practice Address - Fax:617-734-9087
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-18
Last Update Date:2014-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1585782085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology