Loretta Langan-Russo, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01220300 Issued in NJ

Practice address

127 Ark Rd
Mount Laurel, NJ 08054-6302

Phone

(856) 608-7733

Fax

(856) 608-7750

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1992862460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 202",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797639",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ARK RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546302",
            "telephone_number": "856-608-7733",
            "fax_number": "856-608-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGAN-RUSSO",
        "first_name": "LORETTA",
        "name_prefix": "Ms.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01220300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.