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General NPI Number Information
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NPI Number | 1548036783
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Entity Type | Individual
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Provider Name | MIKA LONG FNP
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Gender | Female
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Dates
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Enumeration Date | 11/29/2023
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 511 WEST 157TH STREET
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City | NEW YORK
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State | NY
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Zip | 10032-5058
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Country | US
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Telephone | 212-781-7979
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Fax | 212-781-7963
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Provider Business Mailing Address
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Address Line | 44 W 28TH STREET 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-4212
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Country | US
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Telephone | 212-545-2409
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Fax | 646-312-0481
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 263483
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 858191
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 357798
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License Number State | NY
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