Individual
MRS. DEBRA SUE LONGBINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA C
Contact information
Practice address
6970 ERIE RD, DERBY, NY 14047-9591
(716) 947-9147
(716) 947-5175
Mailing address
6970 ERIE RD, DERBY, NY 14047-9591
(716) 947-9147
(716) 947-5175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001449
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570049002
BCBS OF WNY
NY
05
—
01429712
—
NY
01
—
9512214
INDEPENDENT HEALTH
NY
Enumeration date
10/21/2005
Last updated
04/07/2017
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