Provider Demographics
NPI:1467452227
Name:SEROTOFF, MARJORIE B (MD)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:B
Last Name:SEROTOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3001 EXPRESSWAY DR N STE 100
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5301
Mailing Address - Country:US
Mailing Address - Phone:631-434-1770
Mailing Address - Fax:631-234-6175
Practice Address - Street 1:3001 EXPRESSWAY DR N STE 100
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749
Practice Address - Country:US
Practice Address - Phone:631-434-1770
Practice Address - Fax:631-234-6175
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY150343208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC08053Medicare UPIN