Individual
DR. RICHARD H. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 HARRISON AVE, YACC 4, BOSTON, MA 02118-4001
(617) 414-2080
(617) 414-2090
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71219
MA
207Q00000X
Family Medicine Physician
MD07395
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110047111A
—
MA
05
—
7001685
—
RI
Enumeration date
12/05/2005
Last updated
06/20/2014
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