Healthcare Provider Details

I. General information

NPI: 1326039520
Provider Name (Legal Business Name): NELLY SERENY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S HIGHLAND AVE STE 10
OSSINING NY
10562-5634
US

IV. Provider business mailing address

100 S HIGHLAND AVE STE 10
OSSINING NY
10562-5634
US

V. Phone/Fax

Practice location:
  • Phone: 914-762-1486
  • Fax: 914-762-1166
Mailing address:
  • Phone: 914-762-1486
  • Fax: 914-762-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number132800
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: