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Individual

DR. JEFFREY CLARKE LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
35 LYON ST, NAPLES, NY 14512-9707
(585) 374-2900
(585) 394-2950
Mailing address
PO BOX 249, 35 LYON STREET, NAPLES, NY 14512-0249
(585) 374-2900
(585) 394-2950

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
157100
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01044480
NY
01
157100
NYS LICENSE
NY
01
16-1311940
TAX ID
NY
Enumeration date
07/18/2006
Last updated
03/07/2023
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