# LONGEVOUS MEDICAL HEALTH CARE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174762082
- **Authorized official:** DR. GUORONG DAI (OWNER)
- **Authorized official phone:** (646) 750-2090

## Contact information

- **Practice address:** 825 57TH ST, SUITE 208 2ND REAR, BROOKLYN, NY 11220-3648
- **Practice address phone:** (646) 750-2090
- **Mailing address:** 4028 COLLEGE POINT BLVD, PH110, FLUSHING, NY 11354-5105
- **Mailing address phone:** (646) 750-2090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2009
- **Last updated:** 05/29/2015