Individual
DR. JAIME B LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
35 HOPE DRIVE, SUITES 202/204, HERSHEY, PA 17033-2036
(717) 531-3503
(717) 531-4375
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD433918
PA
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
MD433918
PA
207VX0201X
Gynecologic Oncology Physician
34110
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010213023
—
PA
01
—
127992
MEDICARE
PA
01
—
86080015085259C450
TRIWEST
AZ
05
—
939754
—
AZ
01
—
P00272876
RAILROAD MEDICARE
AZ
01
—
P00670380
RAILROAD MEDICARE - READING PROFESSIONAL SERVICES
PA
Enumeration date
12/09/2005
Last updated
01/11/2019
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