Individual
FREDERICK JONATHAN LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 E 60TH ST, SUITE 1002, NEW YORK, NY 10022-1008
(212) 421-8115
(212) 888-3866
Mailing address
30 E 60TH ST, SUITE 1002, NEW YORK, NY 10022-1008
(212) 421-8115
(212) 888-3866
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
170152
NY
Other
Enumeration date
09/17/2006
Last updated
01/31/2011
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