Broderick D Longo

Primary specialty

Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X

Practice address

535 Sycamore Ave
Shrewsbury, NJ 07702-4224

Phone

(732) 741-0970

NPI assigned

Aug 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1750936704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 DRISCOL DR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242777",
            "telephone_number": "732-600-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 SYCAMORE AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024224",
            "telephone_number": "732-741-0970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 Arnold Ave",
            "address_purpose": "LOCATION",
            "city": "Point Pleasant Beach",
            "state": "NJ",
            "postal_code": "087422531",
            "country_code": "US",
            "telephone_number": "732-295-2582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONGO",
        "first_name": "BRODERICK",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LL Advanced Aesthetics
• Larissa Lobato, N.P.
• Kathy Loder-Murphy, M.A., LCRC
• Amanda M Loeffler, MS, LAC
• Melanie Londono, FNP-C
• Jacqueline Lopresti, DO
• Prakash S Lothe, MD
• Stanley Lu, MD
• Alyssa Grace Lundy, LSW, LCADC
• Jaclyn Nicole Lutz, SLP

• Medical Art Specialist/Technologist in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Medical Art Specialist/Technologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.