Provider Demographics
NPI:1831936277
Name:SERENE PSYCHIATRIC & MEDICAL PRACTICE PLLC
Entity type:Organization
Organization Name:SERENE PSYCHIATRIC & MEDICAL PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:ARHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-348-7148
Mailing Address - Street 1:2 MATTHEW LN
Mailing Address - Street 2:
Mailing Address - City:BROAD BROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06016-1006
Mailing Address - Country:US
Mailing Address - Phone:860-348-7148
Mailing Address - Fax:
Practice Address - Street 1:2 MATTHEW LN
Practice Address - Street 2:
Practice Address - City:BROAD BROOK
Practice Address - State:CT
Practice Address - Zip Code:06016-1006
Practice Address - Country:US
Practice Address - Phone:860-348-7148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty