Individual provider · Type 1 NPI

Nicholas William Longo, PA-C

Medical Physician Assistant · Malvern, PA

NPI number 1508377250 Active

Practice location

325 Central Ave Ste 200
Malvern, PA 19355-3265

Call (610) 644-6755 Map

Mailing address

1504 Fairmount Ave Apt A
Philadelphia, PA 19130-2951

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XOA004323 (PA)
Medical Physician Assistant Primary 363AM0700XMA059486 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1508377250

Nicholas William Longo, PA-C's National Provider Identifier is 1508377250, issued on Oct 21, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Malvern, PA. The record was last updated on Oct 21, 2017.