Individual
MS. BRIANNA NICOLE LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 GRAND ST, NEW BRITAIN, CT 06052-2016
(860) 224-5011
Mailing address
43 CLARK ST, WOLCOTT, CT 06716-1422
(203) 525-1772
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
CT
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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