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General NPI Number Information
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NPI Number | 1811662810
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Entity Type | Individual
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Provider Name | NICOLETTE CAROLYN SERRATORE PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 8835 GERMANTOWN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19118-2718
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Country | US
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Telephone | 215-248-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 3324 FISHER RD
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City | LANSDALE
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State | PA
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Zip | 19446-5720
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Country | US
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Telephone | 215-688-7906
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9120925
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA063881
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License Number State | PA
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