Long Island Neuropsychology, P.c.

NPI #1356467419 in Lake Ronkonkoma, New York

Provider Information

NPI Number: 1356467419
Entity Type: Organization
Organization Name: Long Island Neuropsychology, P.c.
Primary Specialty: Psychologist - Forensic
Enumeration Date: Mar 21, 2007
Last Updated: Sep 11, 2025

Practice Location

Address: 290 HAWKINS AVE
Address 2: SUITE B
City: Lake Ronkonkoma
State: New York
ZIP Code: 11779-9600
Phone: (631) 334-7884

Authorized Official

Name: DR. SHANE S. BUSH, PH.D.
Title: PRESIDENT
Phone: (631) 334-7884

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Neuropsychologist	103G00000X
Psychologist	103T00000X
Psychologist - Clinical — Clinical	103TC0700X
Psychologist - Rehabilitation — Rehabilitation	103TR0400X
Psychologist - Forensic — Forensic	103TF0200X	Primary

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