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General NPI Number Information
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NPI Number | 1497528293
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Entity Type | Individual
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Provider Name | ISAIAH SERRANO
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Gender | Male
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 11/02/2023
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Provider Practice Location Address
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Address Line | 84 W MAIN ST STE 1
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City | EAST ISLIP
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State | NY
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Zip | 11730-2335
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Country | US
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Telephone | 631-383-6520
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Fax |
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Provider Business Mailing Address
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Address Line | 180 NASSAU ST APT 3E
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City | BROOKLYN
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State | NY
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Zip | 11201-2093
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Country | US
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Telephone | 631-992-0975
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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