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1588292122
CODY MICHAEL LONG
PHILADELPHIA, PA
NPI
1588292122
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-30
Last Update Date
2020-03-30
Business Address
DR. CODY MICHAEL LONG MD
800 SPRUCE ST
PHILADELPHIA, PA 19107-6130
Phone number: 215-829-5410
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Mailing Address
DR. CODY MICHAEL LONG MD
305 S 11TH ST APT 1R
PHILADELPHIA, PA 19107-6094
Phone number: 856-417-1859
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