Provider Demographics
NPI:1902686926
Name:SUNSHINE PSYCHIATRIC SERVICE PC
Entity type:Organization
Organization Name:SUNSHINE PSYCHIATRIC SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CREDENTIALING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULYCHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-392-3274
Mailing Address - Street 1:76 PARK LANE DR
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1320
Mailing Address - Country:US
Mailing Address - Phone:347-517-2355
Mailing Address - Fax:
Practice Address - Street 1:6 TUXEDO AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3519
Practice Address - Country:US
Practice Address - Phone:347-517-2335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty