Healthcare Provider Details

I. General information

NPI: 1669907903
Provider Name (Legal Business Name): SERGE SEVY PSYCHIATRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 3RD AVE FL 20
NEW YORK NY
10017-2046
US

IV. Provider business mailing address

757 3RD AVE FL 20
NEW YORK NY
10017-2046
US

V. Phone/Fax

Practice location:
  • Phone: 917-251-6498
  • Fax: 212-861-1584
Mailing address:
  • Phone: 917-251-6498
  • Fax: 212-861-1584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number199003
License Number StateNY

VIII. Authorized Official

Name: SERGE SEVY
Title or Position: PRESIDENT
Credential: MD
Phone: 917-251-6498