| The Long Island Alzheimer's And Dementia Center | |
|
1025 Old Country Rd Ste 115 Westbury NY 11590-5653 | |
| (516) 767-6856 | |
| Not Available |
| Full Name | The Long Island Alzheimer's And Dementia Center |
|---|---|
| Speciality | Social Worker |
| Location | 1025 Old Country Rd Ste 115, Westbury, New York |
| Authorized Official Name and Position | Victoria Lynn Cohen (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5167676856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Long Island Alzheimer's And Dementia Center 1025 Old Country Rd Ste 115 Westbury NY 11590-5653 Ph: () - | The Long Island Alzheimer's And Dementia Center 1025 Old Country Rd Ste 115 Westbury NY 11590-5653 Ph: (516) 767-6856 |
| NPI Number | 1437781929 |
|---|---|
| Provider Enumeration Date | 02/12/2020 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Medicare PECOS PAC ID | 6901226455 |
|---|---|
| Medicare Enrollment ID | O20201021002914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437781929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jillian M Viup |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508292921 PECOS PAC ID: 3971885625 Enrollment ID: I20170113000251 |
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