Provider Demographics
NPI:1477951713
Name:LONG ISLAND PSYCHIATRIC SERVICES - NP IN PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:LONG ISLAND PSYCHIATRIC SERVICES - NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIO0NER IN PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:ZVI
Authorized Official - Middle Name:S
Authorized Official - Last Name:YADIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NP
Authorized Official - Phone:516-456-9384
Mailing Address - Street 1:21 REDWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787
Mailing Address - Country:US
Mailing Address - Phone:516-456-9384
Mailing Address - Fax:631-297-8444
Practice Address - Street 1:21 REDWOOD LN
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2718
Practice Address - Country:US
Practice Address - Phone:516-456-9384
Practice Address - Fax:631-297-8444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400794363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty