MEDICARE: LONG ISLAND LIGHTHOUSE FOR THE VISUALLY IMPAIRED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251300000X	Local Education Agency (LEA)
2	251S00000X	Community/Behavioral Health Agency
3	261QM1300X	Multi-Specialty Clinic/Center
4	261QP2300X	Primary Care Clinic/Center
5	261QR0400X	Rehabilitation Clinic/Center
6	332H00000X	Eyewear Supplier
7	152WL0500X	Low Vision Rehabilitation Optometrist

General Provider Information

NPI Number	:	1346196771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG ISLAND LIGHTHOUSE FOR THE VISUALLY IMPAIRED

Provider Business Mailing Address
First Line	:	464 MERRICK RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1410
Country	:	US
Telephone Number	:	516-208-7596
Fax Number	:	516-825-0112

Provider Business Practice Location Address
First Line	:	464 MERRICK RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-1410
Country	:	US
Telephone Number	:	516-208-7596
Fax Number	:	516-825-0112

Authorized Official
Title or Position	:	LOW VISION REHAB SPECIALIST
Name	:	DR. LUCIEN G PRINCE
Credential	:	OD/MD
Telephone Number	:	516-208-7596

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “LONG ISLAND LIGHTHOUSE FOR THE VISUALLY IMPAIRED ” Practice Location

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