| Little Penguin | |
|
48 Blueberry Lane Staten Island NY 10312 | |
| (718) 967-1585 | |
| (718) 967-1585 |
| Full Name | Little Penguin |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 48 Blueberry Lane, Staten Island, New York |
| Authorized Official Name and Position | Boris Mirochnik (DIRECTOR PSYCHOLOGIST) |
| Authorized Official Contact | 7189671585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Penguin 48 Blueberry Lane State Island NY 10312 Ph: (718) 967-1585 | Little Penguin 48 Blueberry Lane Staten Island NY 10312 Ph: (718) 967-1585 |
| NPI Number | 1720268451 |
|---|---|
| Provider Enumeration Date | 11/09/2007 |
| Last Update Date | 11/09/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720268451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | R065562 (New York) | Primary |
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