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General NPI Number Information
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NPI Number | 1477951713
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PSYCHIATRIC SERVICES - NP IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 21 REDWOOD LN
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City | SMITHTOWN
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State | NY
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Zip | 11787-2718
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Country | US
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Telephone | 516-456-9384
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Fax | 631-297-8444
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Provider Business Mailing Address
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Address Line | 21 REDWOOD LANE
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City | SMITHTOWN
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State | NY
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Zip | 11787
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Country | US
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Telephone | 516-456-9384
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Fax | 631-297-8444
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Authorized Official
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Title or Position | NURSE PRACTITIO0NER IN PSYCHIATRY
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Name | DR. ZVI S YADIN
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Credential | PH.D, NP
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Telephone | 516-456-9384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 400794
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License Number State | NY
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