Andrea Mary Petitto Long, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP045847L Issued in PA

Practice address

1000 Meade St Ste 104
Dunmore, PA 18512-3195

Phone

(570) 961-5100

Fax

(570) 961-8599

NPI assigned

Jun 14, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1992298855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MEADE ST STE 104",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123195",
            "telephone_number": "570-961-5100",
            "fax_number": "570-961-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEADE ST STE 104",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185123195",
            "telephone_number": "570-961-5100",
            "fax_number": "570-961-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETITTO LONG",
        "first_name": "ANDREA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP045847L",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN290719L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Patton, M.S., CADC
• Pennsylvania Ambulance LLC
• Pennsylvania CVS Pharmacy, L.L.C.
• Taylor Perry, D.C.
• Christopher Albert Peters, MD
• PHHC Scranton Hospice, LLC
• PHHC Scranton, LLC
• Joseph F Philbin, MD
• Jennifer Edna Pierce, PAC
• Maura Pinto, LPC

• All providers in Dunmore, PA
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.