OrganizationActive
Little Penguin
NPI 1720268451 · Group Psychotherapy Psychologist · Staten Island, NY
Provider details
- NPI number
- 1720268451
- Entity type
- Organization
- Primary specialty
- Group Psychotherapy PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Boris Mirochnik, Director Psychologist(718) 967-1585
- License
- R065562 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
48 Blueberry Lane
Staten Island, NY 10312
Phone: (718) 967-1585
Fax: (718) 967-1585
Approximate (ZIP-level) locationGet directions
Mailing address
48 Blueberry Lane
State Island, NY 10312
Registry dates
- Enumerated
- 2007-11-09
- Last updated
- 2007-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.