Provider Demographics
NPI:1265044770
Name:SERAFIN, AGNES
Entity Type:Individual
Prefix:
First Name:AGNES
Middle Name:
Last Name:SERAFIN
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 1:100 W 10TH ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-6607
Mailing Address - Country:US
Mailing Address - Phone:302-472-6769
Mailing Address - Fax:
Practice Address - Street 1:100 W 10TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-6607
Practice Address - Country:US
Practice Address - Phone:302-472-6769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator