Individual provider Active NPI

Abiola Longe, M.D

  • Child & Adolescent Psychiatry Physician
  • Suffern, NY
National Provider Identifier
1396939047
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
282155 Issued in NY
Practice address
255 Lafayette Ave
Suffern, NY 10901-4812
Phone
(845) 987-3973
Fax
(845) 987-5979
NPI assigned
Sep 5, 2007
Last updated
May 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 282155 NY Primary
Child & Adolescent Psychiatry Physician 2084P0804X 049705 CT

Addresses

Primary practice location

255 Lafayette Ave
Suffern, NY 10901-4812

Mailing address

20 Grand St FL 3
Warwick, NY 10990-1035
Phone (845) 987-3906

Other identifiers 1

IdentifierTypeStateIssuer
282155OtherNYNY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513000203 NY Order and Referring Only - PsychiatryPractitioner - PsychiatryPractitioner - Addiction Medicine 1456502459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
282155NYMDLicensed Practical Nurse
049705CTMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Office of Mental Health Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1396939047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 GRAND ST FL 3",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109901035",
            "telephone_number": "845-987-3906",
            "fax_number": "845-987-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014812",
            "telephone_number": "845-987-3973",
            "fax_number": "845-987-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGE",
        "first_name": "ABIOLA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "282155",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "049705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY LICENSE",
            "identifier": "282155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.