Individual
MEGHAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1000
Mailing address
2211 LOCUST ST APT L3R, PHILADELPHIA, PA 19103-5569
(860) 461-4542
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP023055
PA
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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