Provider Demographics
NPI:1679838775
Name:LONG ISLAND ALZHEIMER'S AND DEMENTIA CENTER
Entity Type:Organization
Organization Name:LONG ISLAND ALZHEIMER'S AND DEMENTIA CENTER
Other - Org Name:LONG ISLAND ALZHEIMER'S FOUNDATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-767-6856
Mailing Address - Street 1:1025 OLD COUNTRY RD STE 115
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5653
Mailing Address - Country:US
Mailing Address - Phone:516-767-6856
Mailing Address - Fax:516-767-6864
Practice Address - Street 1:1025 OLD COUNTRY RD STE 115
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5653
Practice Address - Country:US
Practice Address - Phone:516-767-6856
Practice Address - Fax:516-767-6864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care