Individual
RALPH S LONGELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
701 GROVE RD, 2ND FLOOR, GREENVILLE, SC 29605-5611
(864) 455-7111
(864) 455-6441
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN801
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20031170
INDIVIDUAL SELECT HEALTH
SC
01
—
20031911
SELECT HEALTH
SC
01
—
430079699
MEDICARE RAILROAD
SC
01
—
576007863
CIGNA
SC
05
—
AN0586
—
SC
Enumeration date
05/19/2006
Last updated
07/11/2012
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