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Organization
LONGJUVE PC
Active
Organization
LONGJUVE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERMIN BERETTA MD (MEDICAL DIRECTOR)
(443) 465-4289
Entity
Organization
Contact information
Practice address
11350 MCCORMICK RD STE 101, HUNT VALLEY, MD 21031-1002
(410) 299-6809
Mailing address
11350 MCCORMICK RD STE 101, HUNT VALLEY, MD 21031-1002
(410) 299-6809
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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