Healthcare Provider Details

I. General information

NPI: 1649023060
Provider Name (Legal Business Name): SERENITY MEDICAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 05/14/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SHERMAN AVE
NEW YORK NY
10040-2669
US

IV. Provider business mailing address

28 SHERMAN AVE
NEW YORK NY
10040
US

V. Phone/Fax

Practice location:
  • Phone: 332-249-2050
  • Fax: 332-249-2051
Mailing address:
  • Phone: 332-249-2050
  • Fax: 332-249-2051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUEY LYN WONG URENA
Title or Position: OWNER
Credential: MD
Phone: 845-603-2515