Individual
DR. ANDREA MARY PETITTO LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1000 MEADE ST STE 104, DUNMORE, PA 18512-3195
(570) 961-5100
(570) 961-8599
Mailing address
1000 MEADE ST STE 104, DUNMORE, PA 18512-3195
(570) 961-5100
(570) 961-8599
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN290719L
PA
183500000X
Pharmacist
Primary
RP045847L
PA
Other
Enumeration date
06/14/2018
Last updated
06/14/2018
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