Mark Richard Serper, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

012107-01 Issued in NY

Practice address

1 Gerard CT
Oceanside, NY 11572-1120

Phone

(516) 286-1373

NPI assigned

Mar 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1134714538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GERARD CT",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721120",
            "telephone_number": "516-286-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GERARD CT",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721120",
            "telephone_number": "516-286-1373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 Commack Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117253400",
            "country_code": "US",
            "telephone_number": "516-286-1373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERPER",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "012107-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Oceanside",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Oceanside",
            "address_1": "1 Gerard Ct",
            "city": "Oceanside",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115721120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Oceanside",
            "affiliation": "N",
            "address_1": "1 Gerard Ct",
            "city": "Oceanside",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115721120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank Paul Scorsese, D.D.S.
• Jasmine Sedaghatpour, DDS
• Eric David Seitelman, MD
• Joanna Lee Selfors
• Dilek Serap Sen, MD
• Caitlin Anne Sessa, NP
• Neal Chirag Shah, DO
• Sumit B Shah, DPM
• Benhoor Shamian, MD
• Jeffrey A Shapiro, DC

• Psychologist in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.