Long, Dennis Sage
Long, Dennis Sage is an sole proprietor health care provider with primary practice located at 488 Montauk Ave , New London CT 06320-4615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Long, Dennis Sage can be contacted via phone (860) 444-2416.Contact Information
Primary practice address
488 Montauk Ave
New London CT 06320-4615
Phone: (860) 444-2416
Fax: (860) 444-0250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 016734 | Connecticut |
Profile Details
| NPI number | 1891790846 |
|---|---|
| LBN Legal business name | Long, Dennis Sage |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 16th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891790846 | NPPES |
| Connecticut | Other | 061734 | CONNECTICARE |
| Connecticut | Other | 010016734CT03 | CONNECTICARE |
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