Basic Information
Provider Information
NPI: 1740617547
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEFERI
FirstName: ARTA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 E 77TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100751850
CountryCode: US
TelephoneNumber: 2124342000
FaxNumber:  
Practice Location
Address1: 100 E 77TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100751850
CountryCode: US
TelephoneNumber: 2124342000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/11/2013
LastUpdateDate: 05/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X337754NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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