NPIMap

Organization Active NPI

Long Island Adolescent & Family Service,Inc

  • Health Service Clinic/Center
  • Stony Brook, NY
National Provider Identifier
1992901722
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
SBH00A09585 Issued in NY
Legal business name
LONG ISLAND ADOLESCENT & FAMILY SERVICE,INC
Practice address
1413 Stony Brook Rd
Stony Brook, NY 11790-2214
Phone
(631) 444-4400
NPI assigned
Jun 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Authorized official

Name
Dr. Diane Aquino
Title
Executive Director
Phone
(631) 444-4400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X SBH00A09585 NY Primary
Health Service Clinic/Center 261QH0100X CH00A09236 NY
Health Service Clinic/Center 261QH0100X RH00A09372 NY
Health Service Clinic/Center 261QH0100X PJ00A09705 NY

Addresses

Primary practice location

1413 Stony Brook Rd
Stony Brook, NY 11790-2214

Mailing address

1413 Stony Brook Rd
Stony Brook, NY 11790-2214

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1992901722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902214",
            "telephone_number": "631-444-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND ADOLESCENT & FAMILY SERVICE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-444-4400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "SBH00A09585",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "CH00A09236",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "RH00A09372",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "PJ00A09705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.