Provider Demographics
NPI:1285605436
Name:LONG ISLAND ENT ASSOCIATES
Entity type:Organization
Organization Name:LONG ISLAND ENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:YOUNGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-931-5552
Mailing Address - Street 1:875 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4942
Mailing Address - Country:US
Mailing Address - Phone:516-931-5552
Mailing Address - Fax:516-931-6563
Practice Address - Street 1:875 OLD COUNTRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4942
Practice Address - Country:US
Practice Address - Phone:516-931-5552
Practice Address - Fax:516-931-6563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW4Y901Medicare ID - Type UnspecifiedGROUP #