Individual
MR. RUSLAN BERDICHEVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
166 VALLEY ST STE 6M103, PROVIDENCE, RI 02909-2458
(401) 566-8175
(401) 340-1697
Mailing address
3335 BAYFIELD BLVD, OCEANSIDE, NY 11572-4621
(401) 566-8175
(401) 340-1697
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.0027653
OH
363LP0200X
Pediatric Nurse Practitioner
APRN.CNP.0027653
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0027653
OH
Other
Enumeration date
11/10/2012
Last updated
02/16/2026
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