Provider Demographics
NPI:1952360273
Name:LONG, GEORGE WEI (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WEI
Last Name:LONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 SAINT GEORGES AVE
Mailing Address - Street 2:SUITE 216
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2764
Mailing Address - Country:US
Mailing Address - Phone:732-396-0777
Mailing Address - Fax:732-396-9222
Practice Address - Street 1:1600 SAINT GEORGES AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2764
Practice Address - Country:US
Practice Address - Phone:732-396-0777
Practice Address - Fax:732-396-9222
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06993300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA06993300OtherSTATE LICENSE
05197322OtherECFMG
190367OtherIM BOARD NUMBER
NJD07707900OtherCDS
NJD07707900OtherCDS
NJ25MA06993300OtherSTATE LICENSE
05197322OtherECFMG