Individual
ELIZA JOSEPHINE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 E MAIN ST, WATERBURY, CT 06705-3815
(203) 709-4030
Mailing address
60 BROAD ST APT 2A, MILFORD, CT 06460-3391
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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