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General NPI Number Information
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NPI Number | 1902686926
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Entity Type | Organization
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Legal Business Name | SUNSHINE PSYCHIATRIC SERVICE PC
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 6 TUXEDO AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3519
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Country | US
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Telephone | 347-517-2335
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Fax |
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Provider Business Mailing Address
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Address Line | 76 PARK LANE DR
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City | ALBERTSON
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State | NY
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Zip | 11507-1320
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Country | US
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Telephone | 347-517-2355
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Fax |
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Authorized Official
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Title or Position | BILLING CREDENTIALING MANAGER
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Name | MS. NATALYA BULYCHEVA
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Credential |
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Telephone | 917-392-3274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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