Provider Demographics
NPI:1528171295
Name:LONGO, FRANK K (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:K
Last Name:LONGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MAPLE STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770
Mailing Address - Country:US
Mailing Address - Phone:203-709-5935
Mailing Address - Fax:203-709-5942
Practice Address - Street 1:58 MAPLE STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770
Practice Address - Country:US
Practice Address - Phone:203-709-5935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT026774207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine