Healthcare Provider Details

I. General information

NPI: 1538063300
Provider Name (Legal Business Name): SERINA ABDUL SATTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 BAY RIDGE AVE
BROOKLYN NY
11220-5906
US

IV. Provider business mailing address

4404 HYLAN BLVD
STATEN ISLAND NY
10312-6404
US

V. Phone/Fax

Practice location:
  • Phone: 718-491-2003
  • Fax:
Mailing address:
  • Phone: 347-786-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: