Provider Demographics
NPI:1568545127
Name:SERPE, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:SERPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2707
Mailing Address - Country:US
Mailing Address - Phone:516-541-3730
Mailing Address - Fax:631-841-0925
Practice Address - Street 1:373 BROADWAY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2707
Practice Address - Country:US
Practice Address - Phone:516-541-3730
Practice Address - Fax:631-841-0925
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215543207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA72196OtherMDNY
NYP2484520OtherOXFORD
NY7555519OtherCIGNA
NY2095414OtherUNITED HEALTHCARE
NY118391OtherVYTRA
NY9639439OtherGHI
NYH35987Medicare UPIN
NY118391OtherVYTRA