National Provider Identifier
Antoinette Rae Long
Antoinette Rae Long is listed in the NPPES registry with a primary specialty of Community Health Worker in Lackawanna, NY and a listed phone number of (716) 828-9699.
Profile Overview
- NPI
- 1609381649
- Provider Type
- Individual
- Primary Specialty
- Community Health Worker
- Enumeration Date
- December 13, 2017
- Last Updated
- December 13, 2017
Practice Location
- 790 Ridge RD
- Lackawanna, NY 14218-1629
Phone: (716) 828-9699
Specialties
- Community Health Worker (172V00000X)
Full Record
- NPI
- 1609381649
- Entity Type
- Individual
- Last Name
- Long
- First Name
- Antoinette
- Middle Name
- Rae
- Mailing Street Address
- 790 Ridge RD
- Mailing City
- Lackawanna
- Mailing State
- NY
- Mailing ZIP Code
- 14218-1629
- Mailing Country
- US
- Mailing Phone
- (716) 828-9699
- Practice Street Address
- 790 Ridge RD
- Practice City
- Lackawanna
- Practice State
- NY
- Practice ZIP Code
- 14218-1629
- Practice Country
- US
- Practice Phone
- (716) 828-9699
- Enumeration Date
- December 13, 2017
- Last Updated
- December 13, 2017
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Community Health Worker (172V00000X)