OrganizationActive
Long Island Neuropsychology, P.C.
NPI 1356467419 · Forensic Psychologist · Lake Ronkonkoma, NY
Provider details
- NPI number
- 1356467419
- Entity type
- Organization
- Primary specialty
- Forensic PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Shane Bush, President(631) 334-7884
- License
- 012998 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
290 Hawkins Ave
Suite B
Lake Ronkonkoma, NY 11779-9600
Phone: (631) 334-7884
Approximate (ZIP-level) locationGet directions
Mailing address
290 Hawkins Ave
Lake Ronkonkoma, NY 11779-9600
Registry dates
- Enumerated
- 2007-03-21
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.