Provider Demographics
NPI:1841458221
Name:LONGSON, AUDREY EVE (DO)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:EVE
Last Name:LONGSON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8 THE GRN # 16016
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:302-603-1005
Mailing Address - Fax:302-546-5700
Practice Address - Street 1:260 CHAPMAN RD STE 205C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5449
Practice Address - Country:US
Practice Address - Phone:302-533-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB092207002084P0800X
DEC2-00130402084P0800X
KY060152084P0800X
OK64402084P0800X
IL0361728982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry