Individual
LONG LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1819 PEACHTREE STREET, SUITE 600, ATLANTA, GA 30309-1848
(404) 350-5777
(404) 350-5755
Mailing address
875 JOHNSON FY RD NE STE 300, ATLANTA, GA 30342-1418
(404) 257-9933
(404) 257-9931
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
99267
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2020
Last updated
01/28/2026
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