Provider Demographics
NPI:1912615428
Name:MINDFUL COGNITION PC
Entity Type:Organization
Organization Name:MINDFUL COGNITION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAGANOVSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:570-540-2590
Mailing Address - Street 1:131 OVERPECK AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1855
Mailing Address - Country:US
Mailing Address - Phone:201-667-2197
Mailing Address - Fax:
Practice Address - Street 1:131 OVERPECK AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1855
Practice Address - Country:US
Practice Address - Phone:201-667-2197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty