Individual
LONG KIM BUI-LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
28-04 BROADWAY, FAIR LAWN, NJ 07410-3913
(201) 791-4434
(201) 791-9377
Mailing address
43 TURNER ST, DOVER, NJ 07801-1728
(973) 366-6645
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00041400
NJ
Other
Enumeration date
05/25/2007
Last updated
06/13/2012
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