Individual
MARIO LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
736 W 181ST ST APT 1I, NEW YORK, NY 10033-4724
(347) 681-1800
Mailing address
566 E 188TH ST APT 2, BRONX, NY 10458-5916
(347) 681-1800
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
16-782
NY
Other
Enumeration date
01/10/2018
Last updated
01/10/2018
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