Jessica Marie Serafin

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

648220 Issued in NY

Practice address

405 Ferndale LN
Minoa, NY 13116-1133

Phone

(315) 857-3711

NPI assigned

Aug 15, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1093433294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 FERNDALE LN",
            "city": "MINOA",
            "state": "NY",
            "postal_code": "131161133",
            "telephone_number": "315-857-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 FERNDALE LN",
            "city": "MINOA",
            "state": "NY",
            "postal_code": "131161133",
            "telephone_number": "315-857-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFIN",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "648220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Katherine Hatch, RN
• Nichole Marie Hosein, HOLISTICPRACTITIONER
• Richard I Levy, DDS
• Kevin Louer, LMSW
• Minoa Nursing and Rehabilitation Center LLC
• Deborah J. Sullivan-Witmer, CCC-SPLP
• Jackey Lynn Toombs, LPN
• Village of Minoa
• Jenna Riley Wright

• All providers in Minoa, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.