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
Fax: (516) 867-0013
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023026754 NPPES
New York MEDICAID 00795840

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