Provider Demographics
NPI:1447263900
Name:LONGOBARDI, VITO ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:VITO
Middle Name:ANTHONY
Last Name:LONGOBARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL FALLS
Mailing Address - State:RI
Mailing Address - Zip Code:02863-2837
Mailing Address - Country:US
Mailing Address - Phone:401-723-2250
Mailing Address - Fax:401-723-5066
Practice Address - Street 1:571 BROAD ST
Practice Address - Street 2:
Practice Address - City:CENTRAL FALLS
Practice Address - State:RI
Practice Address - Zip Code:02863-2837
Practice Address - Country:US
Practice Address - Phone:401-723-2250
Practice Address - Fax:401-723-5066
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI401699OtherTUFTS
RI9023889Medicaid
RI27853OtherNEIGHBORHOOD HEALTHPLAN
RIAA79536OtherHARVARD PILGRIM
RI050520835OtherHCVM
RI23889-4OtherBLUE CROSS/BLUE SHIELD
RI409030OtherBLUE CHIP
RI6399776001OtherCIGNA
RIZC1832OtherBLUE CROSS OF MA
RI0405961OtherUNITED HEALTHCARE
RI2710174OtherAETNA