Provider Demographics
NPI:1013059310
Name:ABELOVE, LAURENCE MARC (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:MARC
Last Name:ABELOVE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 UNION AVE
Mailing Address - Street 2:STE. 3
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3397
Mailing Address - Country:US
Mailing Address - Phone:516-593-8408
Mailing Address - Fax:516-887-9436
Practice Address - Street 1:10 UNION AVE
Practice Address - Street 2:STE. 3
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3397
Practice Address - Country:US
Practice Address - Phone:516-593-8408
Practice Address - Fax:516-887-9436
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009089103G00000X, 103TC0700X, 103TF0200X, 103T00000X
FLPY-0005327103G00000X, 103TC0700X, 103TF0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist