Provider Demographics
NPI:1649874439
Name:SERENITY MOBILE DIAGNOSTICS LLC
Entity type:Organization
Organization Name:SERENITY MOBILE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN NNAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-563-7372
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-0023
Mailing Address - Country:US
Mailing Address - Phone:917-742-8285
Mailing Address - Fax:
Practice Address - Street 1:1469 HAMMERSLEY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3024
Practice Address - Country:US
Practice Address - Phone:917-742-8285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty