Provider Demographics
NPI:1164843629
Name:SEMERLY, SEENA (NP)
Entity Type:Individual
Prefix:
First Name:SEENA
Middle Name:
Last Name:SEMERLY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 75TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3240
Mailing Address - Country:US
Mailing Address - Phone:212-734-3338
Mailing Address - Fax:212-734-1710
Practice Address - Street 1:120 E 75TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3240
Practice Address - Country:US
Practice Address - Phone:212-734-3338
Practice Address - Fax:212-734-1710
Is Sole Proprietor?:No
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381327363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics