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General NPI Number Information
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NPI Number | 1912314808
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Entity Type | Organization
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Legal Business Name | LONG ISLAND COMPREHENSIVE PSYCHIATRY PC
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Dates
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Enumeration Date | 07/13/2014
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 5512 MERRICK RD SUITE 2A
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6233
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Country | US
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Telephone | 516-797-0282
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Fax | 516-797-0284
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Provider Business Mailing Address
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Address Line | 5512 MERRICK RD SUITE 2A
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6233
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Country | US
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Telephone | 516-797-0282
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Fax | 516-797-0284
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARAN KUMAR
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Credential | MD
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Telephone | 516-797-0282
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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 | 142753
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License Number State | NY
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