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NPI Code Detail

MEDICARE: EMILY LONG MD

MEDICARE: EMILY LONG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD19963RI

General Provider Information

NPI Number : 1023675337
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY LONG MD
Provider Business Mailing Address
First Line : 15 LA SALLE SQ
Second Line :
City : PROVIDENCE
State : RI
Zip : 02903-1814
Country : US
Telephone Number : 401-444-6779
Fax Number : 401-444-6912
Provider Business Practice Location Address
First Line : 1454 S COUNTY TRL
Second Line :
City : E GREENWICH
State : RI
Zip : 02818-1749
Country : US
Telephone Number : 401-649-4020
Fax Number : 401-649-4021
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2019
Last Update Date : 03/06/2026

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Directions to “ EMILY LONG MD” Practice Location

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