Active NPI
Catherine G Lange, PA
- Physician Assistant
- Kew Gardens, NY
National Provider Identifier
1497879779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005641
- Practice address
- 12510 Queens Blvd
Kew Gardens, NY 11415-1519 - Phone
- (718) 261-0444
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005641 | NY | Primary |
Addresses
Primary practice location
12510 Queens Blvd
Kew Gardens, NY 11415-1519
Mailing address
4031 157TH St
Flushing, NY 11354-5045
Phone (718) 445-1673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005641 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1497879779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4031 157TH ST",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113545045",
"telephone_number": "718-445-1673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12510 QUEENS BLVD",
"city": "KEW GARDENS",
"state": "NY",
"postal_code": "114151519",
"telephone_number": "718-261-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "CATHERINE",
"middle_name": "G",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "005641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kew Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.