Healthcare Provider Details

I. General information

NPI: 1144473638
Provider Name (Legal Business Name): LAURIE ELLEN GINSBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 BEAUMONT DR
PLAINVIEW NY
11803-2507
US

IV. Provider business mailing address

67 BEAUMONT DR
PLAINVIEW NY
11803-2507
US

V. Phone/Fax

Practice location:
  • Phone: 516-576-2940
  • Fax:
Mailing address:
  • Phone: 516-370-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: