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General NPI Number Information
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NPI Number | 1386728566
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PSYCHOLOGICAL SERVICES COMPANY
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 300 GARDEN CITY PLZ STE 400
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City | GARDEN CITY
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State | NY
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Zip | 11530-3332
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Country | US
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Telephone | 516-248-0006
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Fax | 516-248-0603
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Provider Business Mailing Address
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Address Line | 300 GARDEN CITY PLZ STE 400
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City | GARDEN CITY
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State | NY
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Zip | 11530-3332
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Country | US
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Telephone | 516-248-0006
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Fax | 516-248-0603
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RALPH VICTOR KAPLAN
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Credential | PHD
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Telephone | 516-248-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 007310
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License Number State | NY
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