1912163981 NPI number — INNA SERBIN MEDICAL P.C.

Table of content: (NPI 1912163981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912163981 NPI number — INNA SERBIN MEDICAL P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INNA SERBIN MEDICAL P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912163981
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 E 76TH ST
Provider Second Line Business Mailing Address:
UNIT M3
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10021-2147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-249-5252
Provider Business Mailing Address Fax Number:
212-879-1337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 E 76TH ST
Provider Second Line Business Practice Location Address:
UNIT M3
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021-2147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-249-5252
Provider Business Practice Location Address Fax Number:
212-879-1337
Provider Enumeration Date:
07/30/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SERBIN
Authorized Official First Name:
INNA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-249-5252

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  154750 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 154750 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2162067 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 236AQ2 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7508200 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7922624 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2593675 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com