MEDICARE: CARLOS SERRANO MS, APRN, CPNP-PC

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	363LP0200X	Pediatric Nurse Practitioner	382084	NY
2	163W00000X	Registered Nurse	26NR17873700	NJ
3	163W00000X	Registered Nurse	541475	NY
4	363LP0200X	Pediatric Nurse Practitioner	26NJ15059700	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609945567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS SERRANO MS, APRN, CPNP-PC

Provider Business Mailing Address
First Line	:	26 AUSTIN PL
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3402
Country	:	US
Telephone Number	:	973-655-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 AUSTIN PL
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-3402
Country	:	US
Telephone Number	:	973-655-2800
Fax Number	:

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	12/17/2025

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