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General NPI Number Information
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NPI Number | 1740384205
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Entity Type | Organization
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Legal Business Name | LONG ISLAND AUDIOLOGY, P.C.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 1000 NORTHERN BLVD SUITE 330
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City | GREAT NECK
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State | NY
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Zip | 11021-5312
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Country | US
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Telephone | 516-482-0660
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Fax | 516-482-9131
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Provider Business Mailing Address
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Address Line | 1000 NORTHERN BLVD SUITE 330
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City | GREAT NECK
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State | NY
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Zip | 11021-5312
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Country | US
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Telephone | 516-482-0660
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Fax | 516-482-9131
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. STEPHEN GLASSER
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Credential | AU.D.
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Telephone | 516-482-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 15000003790
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License Number State | NY
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