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General NPI Number Information
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NPI Number | 1467278713
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Entity Type | Organization
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Legal Business Name | NORTH SHORE PSYCHIATRIC ASSOCIATES OF LONG ISLAND, P.C.
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 369 WILLIS AVE LOWR LEVEL
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City | MINEOLA
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State | NY
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Zip | 11501-1842
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Country | US
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Telephone | 516-253-4698
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Fax |
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Provider Business Mailing Address
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Address Line | 2630 REBECCA ST
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City | BELLMORE
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State | NY
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Zip | 11710-5416
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Country | US
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Telephone | 516-458-2522
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ALLISON B DEUTCH
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Credential | MD
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Telephone | 516-458-2522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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