Provider Demographics
NPI:1205200318
Name:HANRAHAN, SERENITY
Entity Type:Individual
Prefix:
First Name:SERENITY
Middle Name:
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1618
Mailing Address - Country:US
Mailing Address - Phone:631-374-0395
Mailing Address - Fax:
Practice Address - Street 1:2975 WESTCHESTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2518
Practice Address - Country:US
Practice Address - Phone:914-305-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant