Healthcare Provider Details

I. General information

NPI: 1245155225
Provider Name (Legal Business Name): EMMA LOVENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 SUNRISE HWY # 304
WANTAGH NY
11793-4024
US

IV. Provider business mailing address

14 SHELBOURNE LN
COMMACK NY
11725-2622
US

V. Phone/Fax

Practice location:
  • Phone: 516-308-4966
  • Fax:
Mailing address:
  • Phone: 631-245-4184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: