Individual provider · Type 1 NPI

Long Kim Bui-Le, PA-C

Surgical Physician Assistant · Fair Lawn, NJ

NPI number 1508077124 Active

Practice location

28-04 Broadway
Fair Lawn, NJ 07410-3913

Fax (201) 791-9377

Mailing address

43 Turner St
Dover, NJ 07801-1728

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X25MP00041400 (NJ)

Surgical Physician Assistant: Definition to come...

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About NPI 1508077124

Long Kim Bui-Le, PA-C's National Provider Identifier is 1508077124, issued on May 25, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Fair Lawn, NJ. The record was last updated on Jun 13, 2012.