Nicole L Luongo, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA057902 Issued in PA

Practice address

325 Central Ave
Suite 200
Malvern, PA 19355-3265

Phone

(610) 644-6755

Fax

(610) 647-2063

NPI assigned

Jan 4, 2016

Last updated

Jan 4, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Rgal Anesthesia Services LLC

  • Anesthesiology Physician
  • Lancaster, PA
  • NPI 1699055251
  NPD (past)

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1770949901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "SELLERSVILLE",
            "state": "PA",
            "postal_code": "189600350",
            "telephone_number": "215-723-2333",
            "fax_number": "215-257-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193553265",
            "telephone_number": "610-644-6755",
            "fax_number": "610-647-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONGO",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Living Changes Therapies
• David F Long, MD
• Nicholas William Longo, PA-C
• Sophie A Longwill
• Samantha Louise
• John Clark Macaulay, D.C.
• Gina Macgillivray
• Archana Machavarapu, M.D.
• Susan Marie Madel, PT
• Magnotta Behavioral Health, LLC

• Medical Physician Assistant in Malvern, PA
• Providers in Malvern, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.