Healthcare Provider Details

I. General information

NPI: 1194043497
Provider Name (Legal Business Name): LONG ISLAND ALZHEIMER'S AND DEMENTIA CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 OLD COUNTRY RD STE 115
WESTBURY NY
11590-5653
US

IV. Provider business mailing address

1025 OLD COUNTRY RD STE 115
WESTBURY NY
11590-5653
US

V. Phone/Fax

Practice location:
  • Phone: 516-767-6856
  • Fax: 516-767-6864
Mailing address:
  • Phone: 516-767-6856
  • Fax: 516-767-6864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA LYNN COHEN
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW
Phone: 516-767-6856