Healthcare Provider Details

I. General information

NPI: 1801138425
Provider Name (Legal Business Name): ANTHONY LONGHINI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 CEDAR ST # STREET3
NEW HAVEN CT
06510-3206
US

IV. Provider business mailing address

333 CEDAR ST # STREET3
NEW HAVEN CT
06510-3206
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-2802
  • Fax:
Mailing address:
  • Phone: 203-785-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number125064338
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number67210
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number67210
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: