National Provider Identifier Database

LONG ISLAND NEUROPSYCHOLOGY PC
Forensic

A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems.


Contact Information

LONG ISLAND NEUROPSYCHOLOGY, P.C.
290 HAWKINS AVE
SUITE B
LAKE RONKONKOMA, NY11779-9600
Phone: 631-334-7884
Fax:
Website:
Specialty Taxonomy Code
* Forensic 103TF0200X
Clinical 103TC0700X
Clinical Neuropsychologist 103G00000X
Psychologist 103T00000X
Rehabilitation 103TR0400X

* Indicates primary specialty

NPI Profile & details for LONG ISLAND NEUROPSYCHOLOGY, P.C.

NPI Number 1356467419
Legal business name
LBN
LONG ISLAND NEUROPSYCHOLOGY, P.C.
Authorized official SHANE BUSH - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 03/21/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • NY License #: 012998

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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