Healthcare Provider Details

I. General information

NPI: 1568966992
Provider Name (Legal Business Name): CHRISTINA ALEXANDRIA SERRET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 BENEDICT AVE STE C
NORWALK OH
44857-2712
US

IV. Provider business mailing address

282 BENEDICT AVE STE C
NORWALK OH
44857-2712
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-4970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036165490
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD481781
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.152101
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: