Provider Demographics
NPI:1851471726
Name:SERBIN, INNA (MD)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:SERBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 76TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2147
Mailing Address - Country:US
Mailing Address - Phone:212-249-5252
Mailing Address - Fax:212-249-5278
Practice Address - Street 1:205 E 76TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2147
Practice Address - Country:US
Practice Address - Phone:212-249-5252
Practice Address - Fax:212-249-5278
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY154750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3C9415OtherHEALTHNET
7508200OtherAETNA
NY236AQ1OtherBLUE CROSS
NY0147279OtherGHI
NYP2162067OtherOXFORD
7922624OtherCIGNA
NY154750OtherHIP
NY236AQ1OtherBLUE CROSS
7508200OtherAETNA