Provider Demographics
NPI:1609201847
Name:SERRANO, EMILIO JOSE (RN)
Entity Type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:JOSE
Last Name:SERRANO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 W 147TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-4404
Mailing Address - Country:US
Mailing Address - Phone:646-257-0534
Mailing Address - Fax:
Practice Address - Street 1:507 W 147TH ST APT 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-4404
Practice Address - Country:US
Practice Address - Phone:646-257-0534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620200163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse