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Dr. Dale Long, MD
Student in an Organized Health Care Education/Training Program in Newington, Connecticut
NPI 1790366912

Dale Long is a Student in an Organized Health Care Education/Training Program based in Farmington, CT. Dale Long practices in Newington, CT and has the professional credentials of MD. The NPI Number for Dale Long is 1790366912 and holds a License No. (Connecticut).

The current practice location address for Dale Long is 555 Willard Ave, Newington, CT and can be reached out via phone at 866-808-7921 and via fax at 860-667-6875.

Location: 555 Willard Ave, Newington, CT, 06030-1921
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1790366912
Provider Name
Dale Long
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
555 Willard Ave, Newington, CT, 06030-1921
Phone Number
866-808-7921
Fax Number
860-667-6875
Provider Enumeration Date
04/19/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
555 Willard Ave
City
Newington
State
Connecticut
Zip
06111-2631
Phone Number
866-808-7921
Fax Number
860-667-6875
person
Provider Business Mailing Address Details
Address
555 Willard Ave
City
Newington
State
Connecticut
Zip
06111-2631
Phone Number
866-808-7921
Fax Number
860-667-6875
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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