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NPI Code Detail

MEDICARE: AMANDA COREY LONG DO

MEDICARE: AMANDA COREY LONG DO
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
1207RG0100XGastroenterology PhysicianOS021830PA

General Provider Information

NPI Number : 1376049981
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA COREY LONG DO
Provider Business Mailing Address
First Line : 2112 HARRISBURG PIKE STE 202
Second Line :
City : LANCASTER
State : PA
Zip : 17601-2644
Country : US
Telephone Number : 516-526-2382
Fax Number :
Provider Business Practice Location Address
First Line : 555 NORTH DUKE STREET
Second Line :
City : LANCASTER
State : PA
Zip : 17602-2250
Country : US
Telephone Number : 717-544-5935
Fax Number : 717-544-8015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2018
Last Update Date : 05/19/2025

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