Individual
MICHAEL V. LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8809
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-8809
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
LP03595
RI
2085R0202X
Diagnostic Radiology Physician
Primary
MD15970
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2015
Last updated
11/11/2022
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