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Individual

DR. SUZANNE S LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
111 S. 11TH STREET, SUITE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6226
(215) 923-1562
Mailing address
111 S. 11TH STREET, SUITE 3390, PHILADELPHIA, PA 19107-4824
(215) 955-6226
(215) 923-1562

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD427698
PA
2085R0202X
Diagnostic Radiology Physician
MT179890
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0231991
NJ
05
102473252
PA
Enumeration date
06/15/2007
Last updated
05/02/2014
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