Provider Demographics
NPI:1912314808
Name:LONG ISLAND COMPREHENSIVE PSYCHIATRY PC
Entity Type:Organization
Organization Name:LONG ISLAND COMPREHENSIVE PSYCHIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-797-0282
Mailing Address - Street 1:5512 MERRICK RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6233
Mailing Address - Country:US
Mailing Address - Phone:516-797-0282
Mailing Address - Fax:516-797-0284
Practice Address - Street 1:5512 MERRICK RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6233
Practice Address - Country:US
Practice Address - Phone:516-797-0282
Practice Address - Fax:516-797-0284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-13
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1427532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty