Provider Demographics
NPI:1053353383
Name:DIPIETRO LONGO, VALERIE (OD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:DIPIETRO LONGO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ROUTE 168
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3233
Mailing Address - Country:US
Mailing Address - Phone:856-227-0720
Mailing Address - Fax:856-227-8550
Practice Address - Street 1:900 ROUTE 168
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3233
Practice Address - Country:US
Practice Address - Phone:856-227-0720
Practice Address - Fax:856-227-8550
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ05014152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0825378000OtherAMERIHEALTH
NJ180021048OtherRAILROAD MEDICARE
NJ571438OtherFIRST HEALTH
NJ2323907Medicaid
NJ01000563700OtherAMERICHOICE
NJ224180OtherUS FAMILY HEALTH PLAN
NJ223048927OtherBCBS
NJ1200178007OtherCIGNA
NJ18343OtherUS HEALTHCARE
NJ0825378000OtherAMERIHEALTH
NJT92337Medicare UPIN