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General NPI Number Information
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NPI Number | 1457232290
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Entity Type | Organization
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Legal Business Name | SPINE CARE MEDICAL LONG ISLAND PC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 110 E MAIN ST STE 4
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City | HUNTINGTON
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State | NY
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Zip | 11743-2845
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Country | US
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Telephone | 516-760-8455
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Fax | 631-824-2755
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Provider Business Mailing Address
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Address Line | 110 E MAIN ST STE 4
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City | HUNTINGTON
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State | NY
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Zip | 11743-2845
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Country | US
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Telephone | 516-760-8455
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Fax | 631-824-2755
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | BERNICE LEONE
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Credential |
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Telephone | 516-760-8455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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