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1114228210
MICHAEL ANTHONY LONGO
STONY BROOK, NY
NPI
1114228210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 014029)
Enumeration Date
2010-11-06
Last Update Date
2018-05-16
Business Address
Mr. MICHAEL ANTHONY LONGO RPA-C
HSC T12 RM 080
STONY BROOK, NY 11794
Phone number: 631-444-1116
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Mailing Address
Mr. MICHAEL ANTHONY LONGO RPA-C
72 PLEASURE AVE
LK RONKONKOMA, NY 11779-4256
Phone number: 631-786-6441
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