Healthcare Provider Details

I. General information

NPI: 1841166287
Provider Name (Legal Business Name): MUK PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PLEASANT ST # 359
MALDEN MA
02148-4906
US

IV. Provider business mailing address

75 PLEASANT ST # 359
MALDEN MA
02148-4906
US

V. Phone/Fax

Practice location:
  • Phone: 617-701-4817
  • Fax: 617-655-9049
Mailing address:
  • Phone: 617-701-4817
  • Fax: 617-655-9049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PETER GALIWANGO
Title or Position: MANAGER
Credential: NP
Phone: 617-701-4817