Provider Demographics
NPI:1023815230
Name:MAGURA PSYCHIATRY AND MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MAGURA PSYCHIATRY AND MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRIY
Authorized Official - Middle Name:V
Authorized Official - Last Name:MAGURA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:440-212-5862
Mailing Address - Street 1:4527 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-3817
Mailing Address - Country:US
Mailing Address - Phone:440-212-5862
Mailing Address - Fax:440-325-3019
Practice Address - Street 1:5522 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2527
Practice Address - Country:US
Practice Address - Phone:440-212-5862
Practice Address - Fax:440-325-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty