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General NPI Number Information
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NPI Number | 1720246606
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Entity Type | Individual
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Provider Name | KATHLEEN MCHUGH LONGO CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | ERIE AVENUE AT FRONT STREET ST CHRISTOPHERS HOSPITAL FOR CHILDREN
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City | PHILADELPHIA
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State | PA
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Zip | 19134
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Country | US
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Telephone | 215-427-4713
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Fax |
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Provider Business Mailing Address
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Address Line | 3102 GEORGETOWN RD
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City | CINNAMINSON
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State | NJ
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Zip | 08077-4455
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Country | US
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Telephone | 856-303-1651
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP0008513
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License Number State | PA
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