Individual
ANNE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 SEA SPRAY DR, CENTERPORT, NY 11721-1633
(516) 639-7122
Mailing address
28 SEA SPRAY DR, CENTERPORT, NY 11721-1633
(516) 639-7122
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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