MEDICARE: CHRISTINE SERRANO-O'LEARY LCSW

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	1041C0700X	Clinical Social Worker	070661-1	NY

General Provider Information

NPI Number	:	1528250222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE SERRANO-O'LEARY LCSW

Provider Business Mailing Address
First Line	:	22 PARSONS DR
Second Line	:
City	:	STONY BROOK
State	:	NY
Zip	:	11790-2615
Country	:	US
Telephone Number	:	631-921-9144
Fax Number	:	866-581-9296

Provider Business Practice Location Address
First Line	:	3771 NESCONSET HWY
Second Line	:	SUITE 208B
City	:	S SETAUKET
State	:	NY
Zip	:	11720-1163
Country	:	US
Telephone Number	:	631-921-9144
Fax Number	:	866-581-9296

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	08/16/2007

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Directions to “ CHRISTINE SERRANO-O'LEARY LCSW” Practice Location

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