Healthcare Provider Details

I. General information

NPI: 1396682860
Provider Name (Legal Business Name): EASTVIEW MEDICAL PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 COLONY AVE
STATEN ISLAND NY
10305-4029
US

IV. Provider business mailing address

121 COLONY AVE
STATEN ISLAND NY
10305-4029
US

V. Phone/Fax

Practice location:
  • Phone: 929-374-3991
  • Fax:
Mailing address:
  • Phone: 718-813-9924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER JOHN MARGULIS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 929-374-3991