Organization Active NPI

Long Island Audiology, P.C.

  • Audiologist
  • Great Neck, NY
National Provider Identifier
1740384205
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
15000003790 Issued in NY
Legal business name
LONG ISLAND AUDIOLOGY, P.C.
Practice address
1000 Northern Blvd
Suite 330
Great Neck, NY 11021-5312
Phone
(516) 482-0660
Fax
(516) 482-9131
NPI assigned
Sep 12, 2006
Reactivated
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Stephen Glasser, AU.D.NPI 1609082791
Title
Director
Phone
(516) 482-0660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 15000003790 NY Primary

Addresses

Primary practice location

1000 Northern Blvd
Suite 330
Great Neck, NY 11021-5312

Mailing address

1000 Northern Blvd
Suite 330
Great Neck, NY 11021-5312
Phone (516) 482-0660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315001310 NY Part B Supplier - Clinic/Group Practice 2567351539 Receives reassigned benefits from 2 practitioners
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Locations

1000 Northern Blvd
Ste 330
Great Neck, NY 11021
Phone (516) 482-0660

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1740384205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 330",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-482-0660",
            "fax_number": "516-482-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NORTHERN BLVD",
            "address_2": "SUITE 330",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215312",
            "telephone_number": "516-482-0660",
            "fax_number": "516-482-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND AUDIOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "deactivation_date": "2006-10-25",
        "reactivation_date": "2007-02-21",
        "status": "A",
        "authorized_official_last_name": "GLASSER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-482-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "NY",
            "license": "15000003790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.