Individual
STACEY LEE LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 CORBETT WAY, PATHOLOGY SOLULTIONS 2ND FLOOR, EATONTOWN, NJ 07724-2263
(732) 389-5200
(732) 389-5299
Mailing address
3600 ROUTE 66 FL 3, NEPTUNE, NJ 07753-2645
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MA67626
NJ
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
25MA06762600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8069204
—
NJ
Enumeration date
11/22/2006
Last updated
03/21/2024
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