Healthcare Provider Details

I. General information

NPI: 1063325280
Provider Name (Legal Business Name): SERENA HILBURN-MICHEL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 COUNTY HIGHWAY 33W STE 3
COOPERSTOWN NY
13326-4955
US

IV. Provider business mailing address

140 COUNTY HIGHWAY 33W STE 3
COOPERSTOWN NY
13326-4955
US

V. Phone/Fax

Practice location:
  • Phone: 607-547-6474
  • Fax:
Mailing address:
  • Phone: 607-547-6474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: