Provider Demographics
NPI:1407965361
Name:LONGO, FRANKLIN B (MD)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:B
Last Name:LONGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1201 NOTT STREET
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308
Mailing Address - Country:US
Mailing Address - Phone:518-374-0483
Mailing Address - Fax:518-374-0515
Practice Address - Street 1:1201 NOTT STREET
Practice Address - Street 2:SUITE 105
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2583
Practice Address - Country:US
Practice Address - Phone:518-374-0483
Practice Address - Fax:518-374-0515
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2014-11-19
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Provider Licenses
StateLicense IDTaxonomies
NY1652961207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01019025Medicaid
10001215OtherCHPHP
000490043001OtherBSNENY
NY01019025Medicaid
NY51347BMedicare UPIN