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1164721247
LISA M LONG
PHILADELPHIA, PA
NPI
1164721247
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: PA SP011280)
Enumeration Date
2011-03-15
Last Update Date
2011-03-15
Business Address
-- LISA M LONG CRNP
51 N 39TH ST 4 PHI
PHILADELPHIA, PA 19104-2640
Phone number: 215-662-9189
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Mailing Address
-- LISA M LONG CRNP
51 NORTH 39TH STREET 4 PHI
PHILADELPHIA, PA 19104-2614
Phone number: 215-662-9189
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