Individual
LI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
620 HOWARD AVE, ALTOONA, PA 16601-4804
(814) 889-2011
Mailing address
5605 ELDORADO AVE, ALTOONA, PA 16601-1037
(814) 656-2081
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
OS022314
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2019
Last updated
07/12/2022
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