Individual
MR. JONATHAN MICHEAL LONGANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PCT
Contact information
Practice address
63 WHITE PINE WAY, MEDFORD, NY 11763-4215
(631) 793-7260
Mailing address
63 WHITE PINE WAY, MEDFORD, NY 11763-4215
(631) 793-7260
Taxonomy
Speciality
Code
Description
License number
State
2472R0900X
Renal Dialysis Technician
Primary
—
NY
Other
Enumeration date
10/08/2015
Last updated
07/21/2022
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