Healthcare Provider Details

I. General information

NPI: 1700875556
Provider Name (Legal Business Name): CORINA SERER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 HICKSVILLE RD SUITE 100
SEAFORD NY
11783-1300
US

IV. Provider business mailing address

2800 MARCUS AVE
LAKE SUCCESS NY
11042-1008
US

V. Phone/Fax

Practice location:
  • Phone: 516-796-9000
  • Fax: 516-796-6360
Mailing address:
  • Phone: 516-622-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number218720
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: