1639180938 NPI number — JOSEPH P LONGHITANO MD

Table of content: JOSEPH P LONGHITANO MD (NPI 1639180938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639180938 NPI number — JOSEPH P LONGHITANO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LONGHITANO
Provider First Name:
JOSEPH
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639180938
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 SAYBROOK ROAD, SUITE A
Provider Second Line Business Mailing Address:
MIDDLESEX CARDIOLOGY ASSOCIATES
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06457-4747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-347-4258
Provider Business Mailing Address Fax Number:
860-704-5924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 SAYBROOK ROAD, SUITE A
Provider Second Line Business Practice Location Address:
MIDDLESEX CARDIOLOGY ASSOCIATES
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06457-4747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-347-4258
Provider Business Practice Location Address Fax Number:
860-704-5924
Provider Enumeration Date:
08/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  042176 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010042176CT04 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2V5417 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3348212 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00142176800 . This is a "BLUE CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042176 . This is a "CT" identifier . This identifiers is of the category "OTHER".