Basic Information
| Provider Information | |||||||||
| NPI: | 1265445266 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANGELAND | ||||||||
| FirstName: | ROLF | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 KINGS HIGHWAY CUTOFF | ||||||||
| Address2: | ORTHOPAEDIC SPECIALTY GRUOP | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068245340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033371900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 75 KINGS HIGHWAY CUTOFF | ||||||||
| Address2: | ORTHOPAEDIC SPECIALTY GROUP | ||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068245340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2033372600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 10/10/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 033759 | CT | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 001337593 | 05 | CT | MEDICAID | 003764 | 01 | CT | HEALTH NET | OTHER | TIN | 01 | GREAT WEST | OTHER | TIN | 01 | NATIONAL PROVIDER NETWORK | OTHER | 033759 | 01 | CT | CONNECTICARE | OTHER | TIN | 01 | CORVEL | OTHER | TIN | 01 | CIGNA | OTHER | 060868382-027 | 01 | CT | CIGNA | OTHER | 86G681 (2) (3) | 01 | CT | EMPIRE | OTHER | P668976 | 01 | CT | OXFORD | OTHER | TIN | 01 | NEATHEAST HEALTH DIRECT | OTHER | TIN | 01 | FIRST HEALTH / CCN | OTHER | TIN | 01 | ORTHONET | OTHER | 0981340 | 01 | CT | AETNA | OTHER | TIN | 01 | NEHCA HMC/ PPO | OTHER | 010033759CT01 | 01 | CT | ANTHEM BC/BS | OTHER | TIN | 01 | POMCO | OTHER | TIN | 01 | PIONEER | OTHER |