Provider Demographics
NPI:1477825263
Name:ALINA A SERDAKOWSKA MD PC
Entity Type:Organization
Organization Name:ALINA A SERDAKOWSKA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SERDAKOWSKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-337-7833
Mailing Address - Street 1:12 STUDIO ARC
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2631
Mailing Address - Country:US
Mailing Address - Phone:914-337-7833
Mailing Address - Fax:914-337-7836
Practice Address - Street 1:12 STUDIO ARC
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2631
Practice Address - Country:US
Practice Address - Phone:914-337-7833
Practice Address - Fax:914-337-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0975921174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY905521Medicare UPIN