Provider Demographics
NPI:1174179048
Name:SERAFINI, SERENITY ANN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:SERENITY
Middle Name:ANN
Last Name:SERAFINI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 CENTRAL AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11221-5234
Mailing Address - Country:US
Mailing Address - Phone:219-951-8297
Mailing Address - Fax:
Practice Address - Street 1:233 BROADWAY RM 2060
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10279-2004
Practice Address - Country:US
Practice Address - Phone:212-233-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY044585OtherPHYSICAL THERAPY LICENSE