| Organization Name: | COGNITIVE-BEHAVIORAL PSYCHOLOGY SERVICES OF LONG ISLAND PLLC |
| NPI Number: | 1144523952 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL B EBERLIN (SOLE MEMBER/OWNER) |
| Mailing Address: | 71 W Main St Suite 1 Oyster Bay |
| State: | NY US |
| Postal Code: | 117712258 |
| Phone Number: | 5165587490 |
| Fax Number: | 8772056740 |
| NPI Enumeration Date: | 12/16/2010 |
| NPI Last Update Date: | 12/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 009143-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |