Provider Demographics
NPI:1740410463
Name:SEROTA, MARCJONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCJONATHAN
Middle Name:
Last Name:SEROTA
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 1:447 ROSE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:844-804-0655
Practice Address - Street 1:2009 W LITTLETON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2003
Practice Address - Country:US
Practice Address - Phone:303-221-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0052146207K00000X
CO521462083B0002X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine