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General NPI Number Information
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NPI Number | 1336379817
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Entity Type | Individual
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Provider Name | STACY SEREBNITSKY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 63134 FITCHETT ST
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-288-7026
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Fax |
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Provider Business Mailing Address
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Address Line | 800 WESTCHESTER AVE STE N715
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City | RYE BROOK
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State | NY
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Zip | 10573-1376
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Country | US
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Telephone | 914-607-5730
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Fax | 914-457-1195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 253492
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 253492
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 253492
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License Number State | NY
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