Individual
DR. DEBORAH LONGO-MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1260 E WOODLAND AVE, SPRINGFIELD, PA 19064-3969
(610) 690-4490
(610) 328-9391
Mailing address
144 GRANDVIEW RD, SPRINGFIELD, PA 19064-1711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS007506L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00169807
—
PA
Enumeration date
01/22/2007
Last updated
07/08/2007
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