| Lish, Inc. | |
|
159 Carleton Ave Central Islip NY 11722-4172 | |
| (631) 650-2510 | |
| (631) 650-0497 |
| Full Name | Lish, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 159 Carleton Ave, Central Islip, New York |
| Authorized Official Name and Position | James Powell (CEO) |
| Authorized Official Contact | 6316502085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lish, Inc. 159 Carleton Ave Central Islip NY 11722-4172 Ph: (631) 650-2510 | Lish, Inc. 159 Carleton Ave Central Islip NY 11722-4172 Ph: (631) 650-2510 |
| NPI Number | 1043663107 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 09/27/2019 |
| Medicare PECOS PAC ID | 5991086225 |
|---|---|
| Medicare Enrollment ID | O20161229000247 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043663107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Sheldon E Winik |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417179151 PECOS PAC ID: 3173510146 Enrollment ID: I20040429001569 |
| Provider Name | Barbara Ann Shultz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215041447 PECOS PAC ID: 8224029442 Enrollment ID: I20040518001143 |
| Provider Name | Janet Pomerantz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1922181510 PECOS PAC ID: 2466443544 Enrollment ID: I20040518001590 |
| Provider Name | Spiro Theoharakis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124004056 PECOS PAC ID: 4880677756 Enrollment ID: I20040610001660 |
| Provider Name | James A Aguirri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992886774 PECOS PAC ID: 1153307798 Enrollment ID: I20040625000142 |
| Provider Name | Joseph M Gagliano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205940038 PECOS PAC ID: 5092776195 Enrollment ID: I20041021001052 |
| Provider Name | Deepika Sood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518170364 PECOS PAC ID: 8820063761 Enrollment ID: I20041229000682 |
| Provider Name | Agnieszka Taormina |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811914831 PECOS PAC ID: 3870548563 Enrollment ID: I20050315001095 |
| Provider Name | Paris A Arianas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467551002 PECOS PAC ID: 8527006402 Enrollment ID: I20050421000019 |
| Provider Name | Gail A Fraser-farmer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841223997 PECOS PAC ID: 8628016268 Enrollment ID: I20050422000865 |
| Provider Name | Andrea C Stengel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235225871 PECOS PAC ID: 9234170226 Enrollment ID: I20050519000869 |
| Provider Name | Jay S Abeles |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164429122 PECOS PAC ID: 6305888926 Enrollment ID: I20050524001044 |
| Provider Name | Jeffrey P Romano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205940046 PECOS PAC ID: 3971545500 Enrollment ID: I20050524001195 |
| Provider Name | Eileen B Flynn Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780671446 PECOS PAC ID: 7012950678 Enrollment ID: I20050604000020 |
| Provider Name | Kevin J Kearney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316043292 PECOS PAC ID: 7810930484 Enrollment ID: I20050604000048 |
| Provider Name | Jerelyn A Silvestro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104917897 PECOS PAC ID: 4587679477 Enrollment ID: I20060214000397 |
| Provider Name | Subbarao Bhimani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164482444 PECOS PAC ID: 6305851940 Enrollment ID: I20060217000429 |
| Provider Name | Brian James Haensly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427131036 PECOS PAC ID: 8022025048 Enrollment ID: I20060316000361 |
| Provider Name | Gina G Patalano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558362426 PECOS PAC ID: 8921008442 Enrollment ID: I20070108000291 |
| Provider Name | Eileen Ingenito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386731784 PECOS PAC ID: 2961581665 Enrollment ID: I20080507000057 |
| Provider Name | John Tsouris |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225032097 PECOS PAC ID: 0749348605 Enrollment ID: I20081021000620 |
| Provider Name | Eugene N Gerardi |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1245324565 PECOS PAC ID: 3971662040 Enrollment ID: I20081104000331 |
| Provider Name | David B Kugler |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1174570147 PECOS PAC ID: 4981798295 Enrollment ID: I20090121000620 |
| Provider Name | Dinesh Shukla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033102280 PECOS PAC ID: 9830237536 Enrollment ID: I20091118000334 |
| Provider Name | Steven M Asofsky |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1629117296 PECOS PAC ID: 8325187867 Enrollment ID: I20091123000528 |
| Provider Name | Raymond Hanson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841377272 PECOS PAC ID: 4486799699 Enrollment ID: I20100226000394 |
| Provider Name | Edward Morvitz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487799748 PECOS PAC ID: 0244424083 Enrollment ID: I20101105000072 |
| Provider Name | Ann Perry Blizzard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245562859 PECOS PAC ID: 5890970297 Enrollment ID: I20110429000027 |
| Provider Name | Lauren M Lindwall |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1437290483 PECOS PAC ID: 4587841994 Enrollment ID: I20110613000616 |
| Provider Name | Christina A Bianchini |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235416397 PECOS PAC ID: 9931374865 Enrollment ID: I20111205000593 |
| Provider Name | Adrienne Manzella |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831236256 PECOS PAC ID: 7012184161 Enrollment ID: I20120113000057 |
| Provider Name | Nancy J Fortin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679623896 PECOS PAC ID: 6800054156 Enrollment ID: I20120216000397 |
| Provider Name | Susan Melnick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366565202 PECOS PAC ID: 1052579315 Enrollment ID: I20120216000439 |
| Provider Name | Courtney L Case |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1255539094 PECOS PAC ID: 4981852886 Enrollment ID: I20120919000131 |
| Provider Name | Lynn E Savino |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346382124 PECOS PAC ID: 9032418652 Enrollment ID: I20160504000418 |
| Provider Name | Judy A. White |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164882338 PECOS PAC ID: 3072804889 Enrollment ID: I20160627001133 |
| Provider Name | Kristin Votteler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124488911 PECOS PAC ID: 7618269200 Enrollment ID: I20160629002192 |
| Provider Name | Joanne Catsounis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689036972 PECOS PAC ID: 0143503086 Enrollment ID: I20170220001227 |
| Provider Name | Natalia Alcantara-lugo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871851568 PECOS PAC ID: 2860764750 Enrollment ID: I20170828003250 |
| Provider Name | Jaclyn Dimattei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093238222 PECOS PAC ID: 0446523211 Enrollment ID: I20170830003220 |
| Provider Name | Kristin Marie Crimi |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1376996793 PECOS PAC ID: 1456611425 Enrollment ID: I20180213000250 |
| Provider Name | Jaclyn A Farino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518486877 PECOS PAC ID: 8628324126 Enrollment ID: I20180712001914 |
| Provider Name | Susan M Trees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912219841 PECOS PAC ID: 3779835335 Enrollment ID: I20181009002042 |
| Provider Name | Peyton-ann Weiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114458015 PECOS PAC ID: 4880930395 Enrollment ID: I20190103002578 |
| Provider Name | Jennifer Anne Obrien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770125833 PECOS PAC ID: 9335576172 Enrollment ID: I20200918002357 |
| Provider Name | Eva Dziergowska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194337253 PECOS PAC ID: 5496169823 Enrollment ID: I20210127000112 |
| Provider Name | Michele Jean Seid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023669348 PECOS PAC ID: 1052727187 Enrollment ID: I20210315001883 |
| Provider Name | Nicole G Balzafiore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568040319 PECOS PAC ID: 6608276779 Enrollment ID: I20210610001740 |
| Provider Name | Anthonia O Onyemem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891460127 PECOS PAC ID: 3870983463 Enrollment ID: I20211214003086 |
| Provider Name | Triz Ann Hebron Dearoz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255099057 PECOS PAC ID: 7618368952 Enrollment ID: I20211222000611 |
| Provider Name | Danielle Williams |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1912527383 PECOS PAC ID: 0749673291 Enrollment ID: I20220207000994 |
| Provider Name | Scott Yung Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518008804 PECOS PAC ID: 8820157670 Enrollment ID: I20221010002338 |
| Provider Name | Cristina Delmonico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437577525 PECOS PAC ID: 8820466931 Enrollment ID: I20221122000120 |
| Provider Name | Ann-marie Spinella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619699618 PECOS PAC ID: 3971972472 Enrollment ID: I20221205002608 |
| Provider Name | Emily Rose Kettell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487119806 PECOS PAC ID: 3476927807 Enrollment ID: I20230324002383 |
| Provider Name | Christina Daniele Riolo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1073244257 PECOS PAC ID: 4082078613 Enrollment ID: I20230914001390 |
| Provider Name | Eileen Marie Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275091563 PECOS PAC ID: 2860842648 Enrollment ID: I20231219003512 |
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