Healthcare Provider Details

I. General information

NPI: 1346196771
Provider Name (Legal Business Name): LONG ISLAND LIGHTHOUSE FOR THE VISUALLY IMPAIRED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 MERRICK RD
OCEANSIDE NY
11572-1410
US

IV. Provider business mailing address

464 MERRICK RD
OCEANSIDE NY
11572-1410
US

V. Phone/Fax

Practice location:
  • Phone: 516-208-7596
  • Fax: 516-825-0112
Mailing address:
  • Phone: 516-208-7596
  • Fax: 516-825-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCIEN G PRINCE
Title or Position: LOW VISION REHAB SPECIALIST
Credential: OD/MD
Phone: 516-208-7596