MR. PETER WARAN LONGA, MSN, APN-C, FNP - NPI NUMBER 1699081547

Summary

Provider Name: MR. PETER WARAN LONGA, MSN, APN-C, FNP

NPI Number: 1699081547

Clasification: Nurse Practitioner (363LF0000X)

Specialization: Family

Address:
701 NEWARK AVE
SUITE 101
ELIZABETH, NJ
ZIP 07208

Phone Number: (908) 872-2669



Detailed Information

MR. Peter Waran Longa, MSN, APN-C, FNP is a family nurse practitioner in Elizabeth, NJ. The assigned NPI number for this provider is 1699081547 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

701 NEWARK AVE
SUITE 101
ELIZABETH, NJ
ZIP 07208-550
Phone: (908) 872-2669

The enumeration date for this NPI number is 8/28/2010 and was last updated on 8/28/2010.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363LF0000X Nurse Practitioner Family 26NJ00288300 NJ Yes

NPI Record

No. Field Name Field Value
1 NPI 1699081547
2 Entity Type Code 1
3 Provider Last Name Legal Name LONGA
4 Provider First Name PETER
5 Provider Middle Name WARAN
6 Provider Name Prefix Text MR.
7 Provider Credential Text MSN, APN-C, FNP
8 Provider First Line Business Practice Location Address 701 NEWARK AVE
9 Provider Second Line Business Practice Location Address SUITE 101
10 Provider Business Practice Location Address City Name ELIZABETH
11 Provider Business Practice Location Address State Name NJ
12 Provider Business Practice Location Address Postal Code 072083550
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 9088722669
15 Provider Enumeration Date 8/28/2010
16 Last Update Date 8/28/2010
17 Provider Gender Code M
18 Healthcare Provider Taxonomy Code 1 363LF0000X
19 Provider License Number 1 26NJ00288300
20 Provider License Number State Code 1 NJ
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor N

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This page was last updated on: 4/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.