Provider Demographics
NPI:1518003433
Name:SERFER, GREGORY T (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:T
Last Name:SERFER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LANSING ST
Mailing Address - Street 2:HOSPITALISTS DEPT
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-1983
Mailing Address - Country:US
Mailing Address - Phone:315-255-7438
Mailing Address - Fax:315-255-7099
Practice Address - Street 1:17 LANSING ST
Practice Address - Street 2:HOSPITALISTS DEPT
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1983
Practice Address - Country:US
Practice Address - Phone:315-255-7438
Practice Address - Fax:315-255-7099
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03600204Medicaid
FL29175ZMedicare ID - Type UnspecifiedMEDICARE
NYJ400088196Medicare PIN
291752Medicare UPIN