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General NPI Number Information
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NPI Number | 1285768978
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Entity Type | Organization
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Legal Business Name | LONG BEACH PSYCHOLOGICAL ASSOCIATES LLP
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2-12 EAST PARK AVE 2ND FLOOR- SOMATIC WELLNESS
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City | LONG BEACH
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State | NY
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Zip | 11561
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Country | US
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Telephone | 516-431-0453
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Fax |
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Provider Business Mailing Address
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Address Line | 32 BAY ST
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City | EAST ATLANTIC BEACH
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State | NY
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Zip | 11561-1002
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Country | US
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Telephone | 516-431-0453
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MAURICE LEVY
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Credential | PH.D.
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Telephone | 516-431-0453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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