Provider Demographics
NPI:1689430340
Name:MIND YOUR MUNCHKIN NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:MIND YOUR MUNCHKIN NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:RUSLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERDICHEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-566-8175
Mailing Address - Street 1:3650 LONG BEACH RD # 1075
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2409 AVENUE Z
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2631
Practice Address - Country:US
Practice Address - Phone:401-566-8175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty