Provider Demographics
NPI:1568725844
Name:SERPIN, NUR (MSED)
Entity Type:Individual
Prefix:
First Name:NUR
Middle Name:
Last Name:SERPIN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:NUR
Other - Middle Name:
Other - Last Name:CINOZGUMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8439 153RD AVE
Mailing Address - Street 2:APT #3N
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1957
Mailing Address - Country:US
Mailing Address - Phone:917-517-4636
Mailing Address - Fax:
Practice Address - Street 1:2625 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3979
Practice Address - Country:US
Practice Address - Phone:718-769-2698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool