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General NPI Number Information
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NPI Number | 1922080126
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Entity Type | Individual
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Provider Name | MARIASTELLA SERRANO MD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 4200 WISCONSIN AVE NW STE 400
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City | WASHINGTON
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State | DC
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Zip | 20016-2100
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Country | US
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Telephone | 202-243-3558
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Fax | 877-680-5504
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Provider Business Mailing Address
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Address Line | 4200 WISCONSIN AVE NW STE 400
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City | WASHINGTON
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State | DC
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Zip | 20016-2100
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Country | US
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Telephone | 202-243-3558
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Fax | 877-680-5504
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | MD045865
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License Number State | DC
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