| Doctor Name: | JAN P LONG |
| NPI Number: | 1174696462 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN ANP-C |
| License Number: | 26NN10757100 |
| Business Practice Address: | 545 Beckett Rd Suite 106 Logan Township, NJ - 080851547 |
| Business Phone Number: | 8564672556 |
| Business Fax Number: | 8564673816 |
| Mailing Address: | 545 Beckett Rd, Suite 106 LOGAN TOWNSHIP |
| State: | NJ |
| Postal Code: | 080851547 |
| Phone Number: | 8564672556 |
| Fax Number: | 8564673816 |
| NPI Enumeration Date: | 11/16/2006 |
| NPI Last Update Date: | 07/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 26NN10757100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |