Provider Demographics
NPI:1376601013
Name:SERINSKY, TODD IAN (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:IAN
Last Name:SERINSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SUGARTOWN RD
Mailing Address - Street 2:SUITE 60
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3029
Mailing Address - Country:US
Mailing Address - Phone:610-687-8988
Mailing Address - Fax:610-687-8944
Practice Address - Street 1:230 SUGARTOWN RD
Practice Address - Street 2:SUITE 60
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3029
Practice Address - Country:US
Practice Address - Phone:610-687-8988
Practice Address - Fax:610-687-8944
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7531628OtherAETNA
PA2400364000OtherINDEPENDENCE BLUE CROSS
PA1695784OtherHIGHMARK
PA7531628OtherAETNA
PA089074Medicare ID - Type Unspecified