Healthcare Provider Details

I. General information

NPI: 1851230353
Provider Name (Legal Business Name): BIG BROTHERS BIG SISTERS OF LONG ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CARLE RD
WESTBURY NY
11590-4147
US

IV. Provider business mailing address

25 CARLE RD
WESTBURY NY
11590-4147
US

V. Phone/Fax

Practice location:
  • Phone: 516-731-7880
  • Fax: 516-731-0486
Mailing address:
  • Phone: 516-731-7880
  • Fax: 516-731-0486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK COX
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 516-842-7678