| Dr Paul R Long, MD | |
|
1155 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | |
| (570) 820-6113 | |
| (570) 808-6349 |
| Full Name | Dr Paul R Long |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 1155 E Mountain Blvd, Wilkes Barre, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649231457 | NPI | - | NPPES |
| 000737850 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | MD019504E (Pennsylvania) | Primary |
| Entity Name | Geisinger Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Paul R Long, MD 100 N Academy Ave, Danville, PA 17822-3034 Ph: (570) 271-6144 | Dr Paul R Long, MD 1155 E Mountain Blvd, Wilkes Barre, PA 18702-7906 Ph: (570) 820-6113 |
Sarah Nicole Telliard, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1155 E Mountain Blvd, Wilkes Barre, PA 18702 Phone: 570-808-6113 Fax: 570-808-6349 | |
Mehul Bhatt, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1155 E Mountain Blvd, Wilkes Barre, PA 18702 Phone: 570-808-6113 Fax: 570-808-6349 | |
Dr. Nil Celebi Cherukuri, MD, PHD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1155 E Mountain Blvd, Wilkes Barre, PA 18702 Phone: 570-808-6113 Fax: 570-808-6349 |