Provider Demographics
NPI:1154356087
Name:JOSEPH B FURLONG PA
Entity type:Organization
Organization Name:JOSEPH B FURLONG PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:FURLONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-771-8346
Mailing Address - Street 1:1111 HAWKINS BLVD
Mailing Address - Street 2:SUITE 2-A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-6421
Mailing Address - Country:US
Mailing Address - Phone:915-771-8346
Mailing Address - Fax:915-771-8347
Practice Address - Street 1:1111 HAWKINS BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-6400
Practice Address - Country:US
Practice Address - Phone:915-771-8346
Practice Address - Fax:915-771-8347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H12747Medicare UPIN