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General NPI Number Information
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NPI Number | 1134103203
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Entity Type | Individual
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Provider Name | PATRICK M LUONGO D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 06/03/2009
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Provider Practice Location Address
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Address Line | 330 W 58TH ST SUITE 503
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City | NEW YORK
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State | NY
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Zip | 10019-1827
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Country | US
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Telephone | 212-262-6215
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Fax | 212-262-6215
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Provider Business Mailing Address
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Address Line | 330 W 58TH ST SUITE 503
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City | NEW YORK
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State | NY
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Zip | 10019-1827
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Country | US
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Telephone | 212-262-6215
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Fax | 212-262-6215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N2670
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 976
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License Number State | FL
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