# LONG ISLAND ORAL SURGERY ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Long Island Center for Oral and Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164614178
- **Authorized official:** DR. JEFFREY ALAN GOLDBERG D.D.S. (PRESIDENT)
- **Authorized official phone:** (516) 921-2880

## Contact information

- **Practice address:** 99 COLD SPRING ROAD, SUITE 3, SYOSSET, NY 11791
- **Practice address phone:** (516) 921-2880
- **Practice address fax:** (516) 921-2889
- **Mailing address:** 99 COLD SPRING ROAD, SUITE 3, SYOSSET, NY 11791
- **Mailing address phone:** (516) 921-2880
- **Mailing address fax:** (516) 921-2889

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 24574 | NY | Yes |

## Other

- **Enumeration date:** 08/14/2007
- **Last updated:** 05/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DOW772 | MEDICARE GROUP NUMBER | — |