Organization
LONG ISLAND SELECT HEALTHCARE, INC.
Active
Other names
LISH, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES POWELL MD (CEO)
(631) 650-2085
Entity
Organization
Contact information
Practice address
75 LANDING MEADOW RD, SMITHTOWN, NY 11787-1124
(631) 650-2510
(631) 650-0497
Mailing address
159 CARLETON AVE, CENTRAL ISLIP, NY 11722-4172
(631) 650-2510
(631) 650-0497
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/13/2016
Last updated
09/27/2019
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