Individual
DR. AIDAN ANGELO LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, COX 201, BOSTON, MA 02114-2696
(617) 726-3850
(617) 724-0239
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-3850
(617) 724-0239
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
72266
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072266
TUFTS HEALTH PLAN
MA
05
—
3077799
—
MA
01
—
J11094
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
04/16/2014
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