Provider Demographics
NPI:1407587926
Name:HASHEM, SERENA (AUDIOLOGY)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:
Last Name:HASHEM
Suffix:
Gender:F
Credentials:AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29183 WOODBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5889
Mailing Address - Country:US
Mailing Address - Phone:315-447-4954
Mailing Address - Fax:
Practice Address - Street 1:1674 SALT SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214
Practice Address - Country:US
Practice Address - Phone:315-447-4954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002906-01231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist