Provider Demographics
NPI:1801216023
Name:SERELIS, VASILIOS (FNP)
Entity Type:Individual
Prefix:MR
First Name:VASILIOS
Middle Name:
Last Name:SERELIS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BRIARWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-6429
Mailing Address - Country:US
Mailing Address - Phone:516-938-0269
Mailing Address - Fax:
Practice Address - Street 1:116 BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-6429
Practice Address - Country:US
Practice Address - Phone:516-938-0269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-27
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338364-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily