Individual
DR. JASON LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
64 DIVISION AVE, SUITE 200, LEVITTOWN, NY 11756-2999
(516) 796-6588
Mailing address
156 DOVER RD, MANHASSET, NY 11030-3710
(516) 515-0457
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
056212
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04304207
—
NY
Enumeration date
04/16/2011
Last updated
10/18/2019
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