Basic Information
Provider Information
NPI: 1285896688
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SERYNEK
FirstName: STEPHEN
MiddleName: BRIAN
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2800 MARCUS AVE
Address2: DEPARTMENT OF INTERNAL MEDICINE SECOND FLOOR
City: NEW HYDE PARK
State: NY
PostalCode: 110421113
CountryCode: US
TelephoneNumber: 7186701231
FaxNumber:  
Practice Location
Address1: 5645 MAIN ST
Address2: DEPARTMENT OF INTERNAL MEDICINE SECOND FLOOR
City: FLUSHING
State: NY
PostalCode: 113555045
CountryCode: US
TelephoneNumber: 7186701231
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2008
LastUpdateDate: 02/09/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X247440NYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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