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 Field Definition 1
1 NPI 1699081547 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name LONGA The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name PETER The first name of the provider, if the provider is an individual.
5 Provider Middle Name WARAN The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text MR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text MSN, APN-C, FNP The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 701 NEWARK AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Second Line Business Practice Location Address SUITE 101 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
10 Provider Business Practice Location Address City Name ELIZABETH The city name in the location address of the provider being identified.
11 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
12 Provider Business Practice Location Address Postal Code 072083550 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
13 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
14 Provider Business Practice Location Address Telephone Number 9088722669 The telephone number associated with the location address of the provider being identified.
15 Provider Enumeration Date 8/28/2010 The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
16 Last Update Date 8/28/2010
17 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
18 Healthcare Provider Taxonomy Code 1 363LF0000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 26NJ00288300
20 Provider License Number State Code 1 NJ The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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