Provider Demographics
NPI:1770303463
Name:MUNA PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:MUNA PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:OGUJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-714-0285
Mailing Address - Street 1:48 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2528
Mailing Address - Country:US
Mailing Address - Phone:215-714-0285
Mailing Address - Fax:215-494-2525
Practice Address - Street 1:3715 GARRETT RD # 1050
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3040
Practice Address - Country:US
Practice Address - Phone:215-714-0285
Practice Address - Fax:215-494-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-16
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty