Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 0101253005 | VA |
N | 207V00000X | Obstetrician & Gynecologist | BP1-0029069 | TX |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 0101253005 | VA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | R7264 | TX |
NPI | 1184815375 |
---|---|
Provider Name | Dr. Monica Longo |
First Address | Baltimore, MD 21297-3174 |
Second Address | Falls Church, VA 22042-3307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4657215830 | MYUTMB 4657215830 (01) |