Provider Demographics
NPI:1255051637
Name:DEUTSCH, SERENA LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:SERENA
Middle Name:LYNN
Last Name:DEUTSCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 58TH ST APT 1D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2333
Mailing Address - Country:US
Mailing Address - Phone:917-697-7653
Mailing Address - Fax:
Practice Address - Street 1:400 E 58TH ST APT 1D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2333
Practice Address - Country:US
Practice Address - Phone:917-697-7653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist