Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Longevity Clinical Ltc Associates of Wisconsin, SC

Organization Family Medicine Physician · NPI 1346922143

Longevity Clinical Ltc Associates of Wisconsin, SC is a Family Medicine Physician in Madison, Wisconsin. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
4

Practice location Address checks out

10 E Doty St Ste 800
Madison, WI 53703-5105
Phone: (608) 441-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Family Medicine) Physician (primary) Taxonomy 207QG0300X
Family Medicine Physician Taxonomy 207Q00000X
Gerontology Nurse Practitioner Taxonomy 363LG0600X
Primary Care Nurse Practitioner Taxonomy 363LP2300X

Record details

NPI number1346922143
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Vincur — Practice Manager · (561) 815-2427
NPI enumeratedAugust 2, 2023
Last updated in NPPESAugust 2, 2023
Certification dateAugust 2, 2023
Mailing address11780 Us Highway 1 Ste N107, North Palm Beach, FL 33408-3007

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