Individual
BRODERICK D LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
535 SYCAMORE AVE, SHREWSBURY, NJ 07702-4224
(732) 741-0970
Mailing address
417 DRISCOL DR, BRICK, NJ 08724-2777
(732) 600-1203
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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