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Individual

DR. TANIKA REONTAE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
30 MEDICAL CENTER BLVD, SUITE 305, UPLAND, PA 19013-3955
(610) 874-6448
(610) 876-7399
Mailing address
30 MEDICAL CENTER BLVD, SUITE 305, UPLAND, PA 19013-3955
(610) 874-6448
(610) 876-7399

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
70297
GA
207L00000X
Anesthesiology Physician
Primary
MD428458
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
428458
MD LICENSE
PA
Enumeration date
05/27/2006
Last updated
04/15/2023
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