Provider Demographics
NPI:1699514281
Name:SHALUKHOVA NP IN ADULT HEALTH AND NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:SHALUKHOVA NP IN ADULT HEALTH AND NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALUKHOVA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:716-380-7874
Mailing Address - Street 1:25 BANK ST APT 212B
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-7004
Mailing Address - Country:US
Mailing Address - Phone:716-380-7874
Mailing Address - Fax:
Practice Address - Street 1:25 BANK ST APT 212B
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-7004
Practice Address - Country:US
Practice Address - Phone:716-380-7874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health