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LONG ISLAND NEUROPSYCHOLOGY, P.C.
NPI 1356467419
Psychologist - Forensic in Lake Ronkonkoma, NY

Active since March 21, 2007
290 HAWKINS AVE, SUITE B, LAKE RONKONKOMA, NY 11779(631) 334-7884 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Long Island Neuropsychology, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LONG ISLAND NEUROPSYCHOLOGY, P.C. (NPI 1356467419) is a healthcare organization registered as a forensic in Lake Ronkonkoma, New York and active in the NPI registry since March 2007. The organization lists Shane S. Bush, President, as its authorized official.

NPPES Registry Identity

NPI1356467419
Entity TypeOrganization
Primary Taxonomy103TF0200X
Legal Business NameLONG ISLAND NEUROPSYCHOLOGY, P.C.
Location Address290 HAWKINS AVE, SUITE BLake Ronkonkoma, NY 11779-9600
Mailing Address290 Hawkins Ave, Suite BLake Ronkonkoma, NY 11779-9600 · (631) 334-7884
Phone(631) 334-7884
Organization SubpartNo
Authorized OfficialShane S. BushPresident · (631) 334-7884
Enumeration DateMarch 21, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1356467419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychologist · ForensicBehavioral Health & Social Service Providers
Taxonomy Code103TF0200X
License✔ Licensed in NY · 012998
Definition
A psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems.
Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License 012998 (NY)
Also ListedPsychologistTaxonomy 103T00000X · License 012998 (NY)
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 012998 (NY)
Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X · License 012998 (NY)
290 HAWKINS AVE, Lake Ronkonkoma, NY 11779
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANE BUSH PH.D.
Clinical Neuropsychologist
290 HAWKINS AVE, SUITE B
LAKE RONKONKOMA, NY 11779
Suffolk County (631) 334-7884
DR. DANA G. BUSH PH.D.
Psychologist (Clinical)
290 HAWKINS AVE, STE. B
LAKE RONKONKOMA, NY 11779
Suffolk County (631) 431-1581
MICHAEL CRETA, DO
Family Medicine
290 HAWKINS AVE
LAKE RONKONKOMA, NY 11779
Suffolk County (631) 981-0045

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Long Island Neuropsychology, P.C.'s NPI number?

The NPI number for Long Island Neuropsychology, P.C. is 1356467419. It was assigned to this organization in the NPPES registry on March 21, 2007.

Where is Long Island Neuropsychology, P.C. located?

Long Island Neuropsychology, P.C. is located at 290 Hawkins Ave Suite B, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 334-7884.

What is Long Island Neuropsychology, P.C.'s specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Forensic, with taxonomy code 103TF0200X.

When was this NPI record last updated?

The NPPES record for Long Island Neuropsychology, P.C. was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.