Provider Demographics
NPI:1770804437
Name:SERINSKY FEIDEN, SANDRA (RN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SERINSKY FEIDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 ULSTER AVE
Mailing Address - Street 2:PO BOX 1850
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1344
Mailing Address - Country:US
Mailing Address - Phone:845-339-6683
Mailing Address - Fax:845-339-7319
Practice Address - Street 1:918 ULSTER AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-1344
Practice Address - Country:US
Practice Address - Phone:845-339-6683
Practice Address - Fax:845-339-7319
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY421679163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)