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LONG ISLAND NEUROPSYCHOLOGY P.C. NPI 1356467419


NPI Information

NPI: 1356467419
Provider Name: LONG ISLAND NEUROPSYCHOLOGY, P.C.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
290 HAWKINS AVE
SUITE B
LAKE RONKONKOMA, NY
ZIP 11779
Phone: (631) 334-7884
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LONG ISLAND NEUROPSYCHOLOGY, P.C. is a clinical neuropsychologist in Lake Ronkonkoma, NY. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. LONG ISLAND NEUROPSYCHOLOGY, P.C. NPI is 1356467419. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

290 HAWKINS AVE
SUITE B
LAKE RONKONKOMA, NY
ZIP 11779-600
Phone: (631) 334-7884

The provider's authorized official is Shane S. Bush .
The authorized official title is President and has the following contact phone number (631) 334-7884.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist012998NEW YORKYes
2103T00000XPsychologist012998NEW YORKX
3103TC0700XPsychologistClinical012998NEW YORKX
4103TF0200XPsychologistForensic012998NEW YORKX
5103TR0400XPsychologistRehabilitation012998NEW YORKX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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