Doctor Name: | MS. MEGAN MELISSA LONG |
NPI Number: | 1043573298 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | OA002872 |
Business Practice Address: | 121 Beech Ave Patton, PA - 166681017 |
Business Phone Number: | 8146745225 |
Business Fax Number: | 8146742338 |
Mailing Address: | 121 Beech Ave, PATTON |
State: | PA |
Postal Code: | 166681017 |
Phone Number: | 8146745225 |
Fax Number: | 8146742338 |
NPI Enumeration Date: | 06/22/2012 |
NPI Last Update Date: | 07/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | OA002872 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |