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NPI Code Detail

MEDICARE: STEPHEN R. LONGO M.D.

MEDICARE: STEPHEN R. LONGO M.D.
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
1207L00000XAnesthesiology PhysicianMD049405LPA

General Provider Information

NPI Number : 1053309609
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN R. LONGO M.D.
Provider Business Mailing Address
First Line : 110 29TH AVE N STE 301
Second Line :
City : NASHVILLE
State : TN
Zip : 37203-6001
Country : US
Telephone Number : 855-331-4999
Fax Number :
Provider Business Practice Location Address
First Line : 252 S 4TH ST
Second Line :
City : LEBANON
State : PA
Zip : 17042-6111
Country : US
Telephone Number : 717-228-1620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 08/03/2015

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Directions to “ STEPHEN R. LONGO M.D.” Practice Location

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