Ricardo Longoria, M.D.

Individual provider Active NPI Specialist · Berwyn Heights, MD

NPI 1073725313 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073725313
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
D0013002 (MD)
Practice address
6201 Greenbelt Rd
Suite M-16
Berwyn Heights, MD 20740-2354
Phone
(301) 598-7585
Fax
(301) 598-7586
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0013002MDMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0013002 MD Yes

Addresses

Primary practice location

6201 Greenbelt Rd
Suite M-16
Berwyn Heights, MD 20740-2354

Mailing address

6201 Greenbelt Rd
Suite M-16
Berwyn Heights, MD 20740-2354
Phone (301) 598-7585

Other providers in Berwyn Heights, MD

All providers in Berwyn Heights, MD · Specialist in Maryland

Sources for this page

Verify at the official NPI Registry.