Provider Demographics
NPI:1003646928
Name:SERPA, TANYA M (MSW)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:M
Last Name:SERPA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 PARKVIEW AVE E
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2845
Mailing Address - Country:US
Mailing Address - Phone:914-602-7333
Mailing Address - Fax:
Practice Address - Street 1:1 LARKIN PLZ
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-7081
Practice Address - Country:US
Practice Address - Phone:914-376-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist