| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KATHARINE RAE LANGE | 1154612463 | 2022-09-18 |
Katharine Rae Lange is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1154612463. Registration indicates Katharine Rae Lange is a provider of access to pediatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Pediatrics (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Pediatrics) (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Katharine Rae Lange MD |
| Practice Office Address | 2525 CHICAGO AVE S MINNEAPOLIS, MN US |
| Practice Office Telephone | 6128136000 |
| Mailing Address | 5901 LINCOLN DRIVE CBC-2-REV/PE EDINA, MN 554361611 US |
| Business Telephone | 9529925691 |
| Business Fax | 9529926917 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1275 York Ave | New York, NY 100656007 | 2126392000 |
| 30 Prospect Ave | Hackensack, NJ 076011915 | 5519962000 |
| Code | Practice | License No State |
|---|---|---|
| 208000000X | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 273683
NY |
| 208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 62945
MN |