Dr. Lance P. Longo MD
Psychiatry Physician in Wauwatosa, WI(View on Map)
Full Name
Dr. Lance P Longo MD
NPI Number
1356458806
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/23/2006
Specialties
(Taxonomies)Code
2084P0800X
2084P0802X
Primary Taxonomy
Yes
No
Licenses
State
Massachusetts
Wisconsin
License Number
74570
37822
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 735044
1220 DEWEY AVE
City
Chicago
Wauwatosa
State
IL
WI
Postal Code
60673-5044
53213-2598
Country
US
US
Telephone Number
(800) 326-2250
(414) 773-4311
Identifiers
Identifier
32273000
Identifier State
WI
Identifier Issuer
Unknown
Health Information Exchange
Endpoint Type
FHIR
DIRECT
Endpoint
https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
llongo9630@direct.myadvocateaurora.org
Endpoint Description
Unknown
Unknown
Use
Unknown
Unknown
Content Type
Unknown
Unknown
Affiliation
N
N
Endpoint Location
1220 Dewey AveWauwatosa, WI532132598US
1220 Dewey AveWauwatosa, WI532132598US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/18/2024
Provider Address
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