Individual
DYAN LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 BOYDEN AVE, MAPLEWOOD, NJ 07040-2480
(973) 378-6001
Mailing address
180 BOYDEN AVE, MAPLEWOOD, NJ 07040-2480
(973) 378-6001
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
06/19/2008
Last updated
06/19/2008
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