Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 282554 | MA |
NPI | 1295142453 |
---|---|
Provider Name | Dr. Zachary Long |
First Address | Pittsfield, MA 01201-4147 |
Second Address | Pittsfield, MA 01201-4147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2014 |
Last Update Date | 12/12/2020 |