Provider Demographics
NPI:1881083087
Name:SERRANO, DEVON FORBES FRANCES (MS, ATC)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:FORBES FRANCES
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MYRTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2319
Mailing Address - Country:US
Mailing Address - Phone:914-834-3613
Mailing Address - Fax:
Practice Address - Street 1:45 MYRTLE BLVD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2319
Practice Address - Country:US
Practice Address - Phone:914-834-3613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer