Provider Demographics
NPI:1336030774
Name:LONG, VINCENT MICHAEL (PT, DPT, NCS, ATP)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:LONG
Suffix:
Gender:M
Credentials:PT, DPT, NCS, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 EDGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1116
Mailing Address - Country:US
Mailing Address - Phone:484-955-2893
Mailing Address - Fax:
Practice Address - Street 1:60 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2220
Practice Address - Country:US
Practice Address - Phone:215-663-6354
Practice Address - Fax:215-663-8891
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist