MEDICARE: DR. CARMINE JOSEPH SCERRA PSY. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	008461	NY
2	103TS0200X	School Psychologist	008461	NY

General Provider Information

NPI Number	:	1528461464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMINE JOSEPH SCERRA PSY. D.

Provider Business Mailing Address
First Line	:	71 CLINTON ROAD
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-9195
Country	:	US
Telephone Number	:	516-396-2292
Fax Number	:	516-396-2227

Provider Business Practice Location Address
First Line	:	71 CLINTON ROAD
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-9195
Country	:	US
Telephone Number	:	516-396-2292
Fax Number	:	516-396-2227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	10/07/2014

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