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General NPI Number Information
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NPI Number | 1417875808
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Entity Type | Individual
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Provider Name | NICHOLAS SERRANO
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Gender |
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 270 PARK AVE
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City | HUNTINGTON
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State | NY
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Zip | 11743-2787
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Country | US
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Telephone | 631-351-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 132 SWEZEY LN
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City | MIDDLE ISLAND
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State | NY
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Zip | 11953-1541
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Country | US
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Telephone | 631-576-9343
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 677498
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 677498
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License Number State | NY
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