Provider Demographics
NPI:1841166287
Name:MUK PSYCHIATRY PLLC
Entity type:Organization
Organization Name:MUK PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIWANGO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:617-701-4817
Mailing Address - Street 1:75 PLEASANT ST # 359
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4906
Mailing Address - Country:US
Mailing Address - Phone:617-701-4817
Mailing Address - Fax:617-655-9049
Practice Address - Street 1:75 PLEASANT ST # 359
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4906
Practice Address - Country:US
Practice Address - Phone:617-701-4817
Practice Address - Fax:617-655-9049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health