Banilivy, Mansour (Max)
Banilivy, Mansour (Max) is an sole proprietor health care provider with primary practice located at 2615 Merrick Ave , Merrick NY 11566-4622. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Banilivy, Mansour (Max) can be contacted via phone (516) 627-9432.Contact Information
Primary practice address
2615 Merrick Ave
Merrick NY 11566-4622
Phone: (516) 627-9432
Fax: (516) 867-0013
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 007526 | New York |
Profile Details
| NPI number | 1023026754 |
|---|---|
| LBN Legal business name | Banilivy, Mansour (Max) |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023026754 | NPPES |
| New York | MEDICAID | 00795840 |
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