Provider Demographics
NPI:1235385170
Name:LONG ISLAND UNIVERSITY
Entity Type:Organization
Organization Name:LONG ISLAND UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RUBENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-299-2437
Mailing Address - Street 1:720 NORTHERN BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1300
Mailing Address - Country:US
Mailing Address - Phone:516-299-2437
Mailing Address - Fax:516-299-3151
Practice Address - Street 1:720 NORTHERN BOULEVARD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:NY
Practice Address - Zip Code:11548-1300
Practice Address - Country:US
Practice Address - Phone:516-299-2437
Practice Address - Fax:516-299-3151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000428-1231H00000X
NY000583-1235Z00000X
NY14000009506237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty