Provider Demographics
NPI:1962617308
Name:LANGER, JENNIFER ELLEN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELLEN
Last Name:LANGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MARTHA JEFFERSON DR FL 4
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4668
Mailing Address - Country:US
Mailing Address - Phone:434-654-8960
Mailing Address - Fax:
Practice Address - Street 1:1221 LEE ST FL 1
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0001
Practice Address - Country:US
Practice Address - Phone:434-924-2706
Practice Address - Fax:434-924-9068
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116017449390200000X
VA01012454602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program