Provider Demographics
NPI:1093572877
Name:LUONGO, ANTHONY BRIAN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BRIAN
Last Name:LUONGO
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1238 LONGMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2202
Mailing Address - Country:US
Mailing Address - Phone:413-636-8037
Mailing Address - Fax:
Practice Address - Street 1:82 NEW PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH FRANKLIN
Practice Address - State:CT
Practice Address - Zip Code:06254-1807
Practice Address - Country:US
Practice Address - Phone:860-889-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant