MEDICARE: SERGINA JEAN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	337548	NY

General Provider Information

NPI Number	:	1073936647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERGINA JEAN FNP

Provider Business Mailing Address
First Line	:	704 JENNINGS AVE
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-3832
Country	:	US
Telephone Number	:	631-796-1888
Fax Number	:

Provider Business Practice Location Address
First Line	:	674 DOGWOOD AVE
Second Line	:
City	:	FRANKLIN SQUARE
State	:	NY
Zip	:	11010-3247
Country	:	US
Telephone Number	:	631-796-1888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2014
Last Update Date	:	04/09/2026

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