Provider Demographics
NPI:1881490019
Name:LONGO, ANGELA (INHC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:LONGO
Suffix:
Gender:
Credentials:INHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BROOK CT
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3103
Mailing Address - Country:US
Mailing Address - Phone:732-221-2011
Mailing Address - Fax:
Practice Address - Street 1:4 BROOK CT
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-3103
Practice Address - Country:US
Practice Address - Phone:732-221-2011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach