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Contact Information

LANCE P LONGO, MD
1220 DEWEY AVE
WAUWATOSA, WI53213-2598
 Phone: 414-773-4311
 Fax: 414-454-6747
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for LANCE P LONGO · (Male)

NPI Number 1356458806
Status Active
Credentials MD
Entity Individual
Enumeration date 08/23/2006
Last updated 09/18/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MA License # 74570
  • WI License # 37822
  • WI Medicaid 32273000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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