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LITTLE PENGUIN NPI 1720268451


NPI Information

NPI: 1720268451
Provider Name: LITTLE PENGUIN
Classification: Psychologist - 103TP2701X
Entity Type: Organization

Specialization: Group Psychotherapy

Address:
48 BLUEBERRY LANE
STATEN ISLAND, NY
ZIP 10312
Phone: (718) 967-1585
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LITTLE PENGUIN is a group psychotherapy psychologist in Staten Island, NY. The provider is a psychologist who specializes in group psychology and group psychotherapy that is an evidenced-based specialty that prepares group leaders to identify and capitalize on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individual group members as well as collectively for the group. Emphasis is placed on the use of group dynamics to assist and treat individual group members. The specialty is applicable to all age groups, children, adolescents, adults and older adults, for a wide variety of conditions and concerns, and in numerous and diverse settings. LITTLE PENGUIN NPI is 1720268451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

48 BLUEBERRY LANE
STATEN ISLAND, NY
ZIP 10312
Phone: (718) 967-1585
Fax: (718) 967-1585

The provider's authorized official is Boris Mirochnik .
The authorized official title is Director Psychologist and has the following contact phone number (718) 967-1585.

The enumeration date for this NPI number is 11/9/2007 and was last updated on 11/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP2701XPsychologistGroup PsychotherapyR065562NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1N3W281MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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