Provider Demographics
NPI:1336373497
Name:INNA SERBIN MD PC
Entity Type:Organization
Organization Name:INNA SERBIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SERBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-249-5252
Mailing Address - Street 1:205 E 76TH ST
Mailing Address - Street 2:SUITE M-3
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:SUITE M-3
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY154750OtherLISENCE
NY154750OtherLISENCE