Provider Demographics
NPI:1508953415
Name:LONGENECKER, MARGOT NORMAN (ND)
Entity Type:Individual
Prefix:DR
First Name:MARGOT
Middle Name:NORMAN
Last Name:LONGENECKER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 WHALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1703
Mailing Address - Country:US
Mailing Address - Phone:203-387-5015
Mailing Address - Fax:203-387-3500
Practice Address - Street 1:1079 WHALLEY AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1703
Practice Address - Country:US
Practice Address - Phone:203-387-5015
Practice Address - Fax:203-387-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000244175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath