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General NPI Number Information
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NPI Number | 1841166287
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Entity Type | Organization
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Legal Business Name | MUK PSYCHIATRY PLLC
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 75 PLEASANT ST # 359
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City | MALDEN
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State | MA
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Zip | 02148-4906
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Country | US
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Telephone | 617-701-4817
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Fax | 617-655-9049
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Provider Business Mailing Address
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Address Line | 75 PLEASANT ST # 359
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City | MALDEN
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State | MA
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Zip | 02148-4906
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Country | US
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Telephone | 617-701-4817
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Fax | 617-655-9049
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Authorized Official
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Title or Position | MANAGER
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Name | PETER GALIWANGO
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Credential | NP
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Telephone | 617-701-4817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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