Provider Demographics
NPI:1770674970
Name:LONGO, LISA SUSAN (PHARMD, BCPS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:SUSAN
Last Name:LONGO
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 M U UNIVERSITY DRIVE C
Mailing Address - Street 2:VA PITTSBURGH HEALTHCARE SYSTEM
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-688-6000
Mailing Address - Fax:412-688-6193
Practice Address - Street 1:132 M U UNIVERSITY DRIVE C
Practice Address - Street 2:VA PITTSBURGH HEALTHCARE SYSTEM
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240
Practice Address - Country:US
Practice Address - Phone:412-688-6000
Practice Address - Fax:412-688-6193
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042052R1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy