Provider Demographics
NPI:1356494231
Name:SERURE, DONNA APRIL (DO)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:APRIL
Last Name:SERURE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2905
Mailing Address - Country:US
Mailing Address - Phone:631-979-0909
Mailing Address - Fax:631-979-0455
Practice Address - Street 1:327 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2905
Practice Address - Country:US
Practice Address - Phone:631-979-0909
Practice Address - Fax:631-979-0455
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205536-1207N00000X, 207ND0101X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2K3501OtherBC/BS PROVIDER ID
NYWEH671Medicare PIN
NY2K3501OtherBC/BS PROVIDER ID