Individual
LALIDA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-BC
Contact information
Practice address
140 HAZARD AVE, ENFIELD, CT 06082-5423
(860) 714-9733
Mailing address
239 CEDAR RIDGE DR, GLASTONBURY, CT 06033-1815
(203) 317-0608
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8578
CT
Other
Enumeration date
11/29/2019
Last updated
08/25/2021
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