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NPI Profile for BRODERICK D LONGO in SHREWSBURY, NJ.
Deactivation Date: 3/31/2023
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Art Specialist/Technologist |
246ZA2600X |
| NPI # | 1750936704 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 08/07/2019 | |
| Last updated | 08/07/2019 - About 7 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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BRODERICK D LONGO