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General NPI Number Information
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NPI Number | 1942525324
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Entity Type | Individual
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Provider Name | JESSICA MCGUIRE LONG MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 06/27/2014
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Provider Practice Location Address
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Address Line | 4900 MASSACHUSETTS AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20016-4358
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Country | US
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Telephone | 202-966-5000
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Fax | 202-966-3830
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Provider Business Mailing Address
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Address Line | 4900 MASSACHUSETTS AVENUE NW
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City | WASHINGTON
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State | DC
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Zip | 20016
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Country | US
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Telephone | 202-966-5000
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Fax | 202-966-3830
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD041707
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License Number State | DC
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