Provider Demographics
NPI:1295142453
Name:LONG, ZACHARY (DO)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:LONG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1330 ALA MOANA BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4200
Mailing Address - Country:US
Mailing Address - Phone:808-585-8855
Mailing Address - Fax:
Practice Address - Street 1:1330 ALA MOANA BLVD FL 4
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4200
Practice Address - Country:US
Practice Address - Phone:808-585-8855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2825542086S0122X
CODR.00728332086S0122X
HIDOS-20752086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery