Individual
DR. ERIC WARREN LONGENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
217 KING ST, LAPORTE, PA 18626
(570) 946-5101
(570) 946-4341
Mailing address
PO BOX 824112, PHILADELPHIA, PA 19182-4112
(215) 871-6910
(215) 871-6905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD027396E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000945182
—
PA
01
—
001730
FIRST PRIORITY HEALTH
PA
01
—
138091
HIGHMARK BLUE SHIELD
PA
01
—
177535
UNITEDHEALTHCARE
PA
01
—
923651
AETNA
PA
01
—
B38831
HEALTHAMERICA
PA
Enumeration date
03/23/2006
Last updated
03/08/2016
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