DR. STACY LIN LONGO (NPI# 1225554140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225554140 |
| Entity Type | Individual |
| Full Name | DR. STACY LIN LONGO |
| Credential | PHARMD |
| Practice Address |
55 Dimock St Roxbury MA 02119-1029 |
| Mailing Address |
94 Smith Ave Apt A Norwich CT 06360-3375 |
| Practice Telephone | 6174428800 |
| Mailing Telephone | 8606256834 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
PH237564 | MA | Pharmacy Service Providers |
| Street Address |
55 DIMOCK ST |
| City | ROXBURY |
| State | MA |
| Zip Code | 02119-1029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831197896 | Kelly Flynn | Obstetrics & Gynecology | 55 Dimock St, Roxbury, MA 02119-1029 | 2005-07-13 |
| 1114574019 | Mary Rose Maiullari | Pharmacist | 55 Dimock St, Roxbury, MA 02119-1029 | 2019-08-25 |
| 1508421033 | Zachary Biedermann | Developmental Therapist | 55 Dimock St, Roxbury, MA 02119-1029 | 2019-05-09 |
| 1851858401 | Yvelande Boursiquot | Social Worker | 55 Dimock St, Roxbury, MA 02119-1029 | 2019-03-01 |
| 1790268837 | Danielle Sharon Ederi | Counselor | 55 Dimock St, Roxbury, MA 02119-1029 | 2018-09-14 |
| 1225527914 | Jevae Nelson | Dentist | 55 Dimock St, Roxbury, MA 02119-1029 | 2018-05-08 |
| 1760996821 | Rachel Shotkin | Social Worker | 55 Dimock St, Roxbury, MA 02119-1029 | 2017-11-28 |
| 1568981421 | Marzieh Bonakdarhashemi | Counselor | 55 Dimock St, Roxbury, MA 02119-1029 | 2017-09-12 |
| 1639624703 | Cindy Stafford | Counselor | 55 Dimock St, Roxbury, MA 02119-1029 | 2016-08-18 |
| 1205289634 | Alice Han | Obstetrics & Gynecology | 55 Dimock St, Roxbury, MA 02119-1029 | 2016-07-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427661644 | Christina Kim Hunt | Case Manager/Care Coordinator | 75 Amory St, Garden Level, Boston, MA 02119 | 2020-08-27 |
| 1962021089 | Taha Fathima Khan | Student in an Organized Health Care Education/Training Program | Boston Medical Center, 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-04-09 |
| 1154957132 | Katherine Erin Douglas | Pediatrics | 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-03-21 |
| 1720536568 | Ramy Y Barrett | Counselor | 77 Savin Street, Apartment # 3, Boston, MA 02119 | 2016-09-21 |
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1922478486 | Natalie Jones | Counselor | 520 Dudley St., Roxbury, MA 02119 | 2015-09-28 |
| 1922484799 | Dina Ghaly-habib | Student in an Organized Health Care Education/Training Program | 100 East Newton St., G-706, Boston, MA 02119 | 2015-08-04 |
| 1942697248 | Pyramid Builders | Case Management | 11 Roxbury Street, Boston, MA 02119 | 2015-04-24 |
| 1063810984 | Sophia Smalls | Counselor | 250 Walnut Ave, Apt. 10, Boston, MA 02119 | 2014-12-09 |
| 1750705059 | Alasa Hawkins | Counselor | 502 Dudley St, Roxbury, MA 02119 | 2014-02-07 |
| Find all providers in zip 02119 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235685769 | Kieran Fennell | Pharmacist | 29 Windsor Dr, Whitman, MA 02382-1049 | 2016-08-25 |
| 1417329244 | Donato Mazzola | Pharmacist | 17 Gilbert St, West Newton, MA 02465-2210 | 2015-10-20 |
| 1497352785 | Kelli Sims | Pharmacist | 485 Arsenal St, Watertown, MA 02472-5091 | 2020-10-08 |
| 1538777164 | Neiloofar Jafari | Pharmacist | 73d Winthrop Ave, Lawrence, MA 01843-3716 | 2020-07-20 |
| 1982231486 | Peter Shupenes | Pharmacist | 800 Washington St, Boston, MA 02111-1552 | 2020-03-25 |
| 1336775436 | Kristen Lynn Carrier | Pharmacist | 800 Washington St, Boston, MA 02111-1552 | 2020-03-20 |
| 1306472402 | Justin Solomon | Pharmacist | 800 Washington St, Boston, MA 02111-1552 | 2020-03-20 |
| 1871129643 | Lei Zou | Pharmacist | 110 W Squantum St, North Quincy, MA 02171-2122 | 2020-03-12 |
| 1942835830 | Malerie Fiedler | Pharmacist | 1249 Boylston St, Boston, MA 02215-3417 | 2020-03-11 |
| 1578109997 | Anna Dutton | Pharmacist | 800 Washington St, Boston, MA 02111-1552 | 2019-11-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.