Provider Demographics
NPI:1366561128
Name:LONGEVITY MEDICAL ARTS, PLLC
Entity type:Organization
Organization Name:LONGEVITY MEDICAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TRANESE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:917-589-4482
Mailing Address - Street 1:9907 3RD AVE APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7946
Mailing Address - Country:US
Mailing Address - Phone:917-589-4482
Mailing Address - Fax:212-656-1336
Practice Address - Street 1:9907 3RD AVE APT 4B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7946
Practice Address - Country:US
Practice Address - Phone:917-589-4482
Practice Address - Fax:212-656-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231468208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
133936687OtherUPN ELITE
2666402OtherUNITEDHEALTHCARE
0112078OtherGHI
NY231468-60OtherLOCAL 1199
231468N02OtherHIP
P3677835OtherOXFORD FREEDOM PLAN
P3677835OtherOXFORD MEDICARE
0M1292OtherHEALTHNET
1639J1OtherEMPIRE BLUE CROSS BLUE SH
5438003OtherCIGNA
5438003OtherCIGNA
=========OtherMAGNACARE
P3677835OtherOXFORD FREEDOM PLAN
1639J1OtherEMPIRE BLUE CROSS BLUE SH
=========OtherEMPIRE NYS PLAN
=========OtherBEECHSTREET
P3677835OtherOXFORD MEDICARE
=========OtherONE HEALTH GW HEALTHCARE