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General NPI Number Information
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NPI Number | 1619397023
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Entity Type | Individual
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Provider Name | MR. ERIC LUONGO
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Gender | Male
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 4000 COAST GUARD BLVD
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City | PORTSMOUTH
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State | VA
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Zip | 23703-2135
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Country | US
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Telephone | 757-686-6789
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Fax | 757-483-8610
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Provider Business Mailing Address
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Address Line | 6800 BURBAGE LAKE CIR
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City | SUFFOLK
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State | VA
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Zip | 23435-2914
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Country | US
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Telephone | 757-377-0035
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Fax | 757-483-8610
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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 | 2470A2800X
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Taxonomy Name | Assistant Health Information Record Technician
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License Number |
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License Number State |
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