Provider Demographics
NPI:1598397044
Name:LONG ISLAND CHILD & ADOLESCENT PSYCHIATRY, P.C.
Entity Type:Organization
Organization Name:LONG ISLAND CHILD & ADOLESCENT PSYCHIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARGULIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-388-3505
Mailing Address - Street 1:40 VARSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1070
Mailing Address - Country:US
Mailing Address - Phone:631-804-7542
Mailing Address - Fax:631-364-9379
Practice Address - Street 1:50 ROUTE 111 STE 101
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3700
Practice Address - Country:US
Practice Address - Phone:631-388-3505
Practice Address - Fax:631-364-9379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty