Provider Demographics
NPI:1629013495
Name:NEUROLOGICAL ASSOCIATES OF LONG ISLAND, PC
Entity Type:Organization
Organization Name:NEUROLOGICAL ASSOCIATES OF LONG ISLAND, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KORETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-466-4700
Mailing Address - Street 1:1991 MARCUS AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2057
Mailing Address - Country:US
Mailing Address - Phone:516-466-4700
Mailing Address - Fax:516-466-4810
Practice Address - Street 1:1991 MARCUS AVENUE
Practice Address - Street 2:SUITE 110
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042-2057
Practice Address - Country:US
Practice Address - Phone:516-466-4700
Practice Address - Fax:516-466-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY41996OtherAETNA INS
NY41996OtherAETNA INS
NY=========OtherFIRST HEALTH
NY=========OtherCIGNA HEALTHCARE
NY=========OtherMULTIPLAN
NY=========OtherOXFORD HEALTH PLANS
NY=========OtherPHCS
NY=========OtherSELECT PRO
OH=========OtherONE HEALTH PLAN
NY=========OtherPHS
NY=========OtherEMPIRE BLUE CROSS
NY=========OtherAMERIHEALTH
NY=========OtherANTHEM
NY=========OtherUNITEDHEALTHCARE/EMPIRE
NY=========OtherBEECH STREET
NY=========OtherHORIZON HEALTHCARE
NY=========OtherEMPIRE BLUE CROSS