LONG ISLAND NEUROPSYCHOLOGY, P.C.

LAKE RONKONKOMA, NY
NPI1356467419
Entity TypeOrganization
Authorized ContactSHANE S. BUSH
President
631-334-7884
Organization Subpart ?No
Primary Taxonomy103G00000X Clinical Neuropsychologist
(Licence: NY  012998)
Additional Taxonomies103T00000X Psychologist
(Licence: NY  012998)
103TC0700X Psychologist, Clinical
(Licence: NY  012998)
103TF0200X Psychologist, Forensic
(Licence: NY  012998)
103TR0400X Psychologist, Rehabilitation
(Licence: NY  012998)
Enumeration Date2007-03-21
Last Update Date2020-08-22
Business Address
LONG ISLAND NEUROPSYCHOLOGY, P.C.
290 HAWKINS AVE SUITE B
LAKE RONKONKOMA, NY 11779-9600
Phone number: 631-334-7884
Mailing Address
LONG ISLAND NEUROPSYCHOLOGY, P.C.
290 HAWKINS AVE SUITE B
LAKE RONKONKOMA, NY 11779-9600
Phone number: 631-334-7884