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Individual

HEATHER LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
315 S MANNING BLVD, @ ST. PETER'S HOSPITAL ER DEPT., ALBANY, NY 12208-1707
(518) 383-5450
(518) 328-3422
Mailing address
225 PEAK RD, STONE RIDGE, NY 12484-5454
(845) 687-8960
(845) 687-8960

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
213463-1
NY
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
213463-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02433489
NY
Enumeration date
07/31/2006
Last updated
01/07/2009
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