Provider Demographics
NPI:1447441431
Name:ISLAND NEURODIAGNOSTICS
Entity type:Organization
Organization Name:ISLAND NEURODIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTTO-LAVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-822-2230
Mailing Address - Street 1:824 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4950
Mailing Address - Country:US
Mailing Address - Phone:516-822-2230
Mailing Address - Fax:516-822-0163
Practice Address - Street 1:824 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4950
Practice Address - Country:US
Practice Address - Phone:516-822-2230
Practice Address - Fax:516-822-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty