Provider Demographics
NPI:1124119532
Name:LONG, WILLIAM E JR
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:LONG
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NUTE RD
Mailing Address - Street 2:
Mailing Address - City:MADBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03823-7500
Mailing Address - Country:US
Mailing Address - Phone:603-749-2263
Mailing Address - Fax:
Practice Address - Street 1:361 HIGH ST
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1407
Practice Address - Country:US
Practice Address - Phone:603-692-4500
Practice Address - Fax:603-692-4520
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHH0302237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist