Longjuve PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

LONGJUVE PC

Practice address

11350 McCormick Rd Ste 101
Hunt Valley, MD 21031-1002

Phone

(410) 299-6809

NPI assigned

Nov 25, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Fermin Beretta, MD

Title

Medical Director

Phone

(443) 465-4289

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1336965458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD STE 101",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "410-299-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD STE 101",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "410-299-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGJUVE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "BERETTA",
        "authorized_official_first_name": "FERMIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "443-465-4289",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Temera Little
• Alicia Lloyd
• Alora Lockhart, LMSW
• Karlee Logsdon
• Tomisin Longe
• Mary Lonnen, COTA
• Marien Lopez-Feliciano
• Ronald Lopez
• Santino Lopez
• Shannon Nicole Lopez, PA

• Medical Specialty Clinic/Center in Hunt Valley, MD
• Providers in Hunt Valley, MD by specialty
• Medical Specialty Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.