Provider Demographics
NPI:1922429471
Name:LUONGO, DOROTHY LISA (FNP-C)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:LISA
Last Name:LUONGO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LEAVEY DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4437
Mailing Address - Country:US
Mailing Address - Phone:603-472-5860
Mailing Address - Fax:603-472-5918
Practice Address - Street 1:25 LEAVEY DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-4437
Practice Address - Country:US
Practice Address - Phone:603-472-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-31
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN282001163W00000X, 363LF0000X
NH059823-21163W00000X
NH059823-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse