Healthcare Provider Details

I. General information

NPI: 1679612956
Provider Name (Legal Business Name): EUGENE SERAFIM DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 EXTON CMNS
EXTON PA
19341-2446
US

IV. Provider business mailing address

776 TREE LN
WEST CHESTER PA
19380-2000
US

V. Phone/Fax

Practice location:
  • Phone: 610-368-5372
  • Fax: 610-524-4184
Mailing address:
  • Phone: 610-692-5547
  • Fax: 610-363-6619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC007284L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC007284L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: