Provider Demographics
NPI:1932350113
Name:LONG, ROBERT THOMAS (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:THOMAS
Last Name:LONG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019422225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
50081213OtherKEYSTONE HEALTH PLAN CENTRAL
1568025OtherGATEWAY HEALTH PLAN
3546063000OtherINDEPENDENCE BLUE CROSS
4626140OtherCIGNA HEALTHCARE
47241OtherGEISINGER HEALTH PLAN
3546063000OtherKEYSTONE HEALTH PLAN EAST
50081213OtherCAPITAL BLUE CROSS
6687477OtherAETNA HMO
2070657OtherHIGHMARK BLUE SHIELD
3546063000OtherAMERIHEALTH
5500503OtherAETNA PPO
50081213OtherCAPITAL BLUE CROSS