Long, Antoinette Rae

Long, Antoinette Rae is an individual health care provider with primary practice located at 790 Ridge Rd , Lackawanna NY 14218-1629. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Long, Antoinette Rae can be contacted via phone (716) 828-9699.

Contact Information

Primary practice address
790 Ridge Rd Lackawanna NY 14218-1629
Phone: (716) 828-9699
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1609381649
LBN Legal business name Long, Antoinette Rae
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2017
Last updated Dec 13th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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