Organization Active NPI

Serenity Anesthesia

  • Anesthesiology Physician
  • Staten Island, NY
National Provider Identifier
1316250012
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
203323 Issued in NY
Legal business name
SERENITY ANESTHESIA
Practice address
1800 Clove Rd
Staten Island, NY 10304-1616
Phone
(914) 582-4577
NPI assigned
Jul 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Dr. Marci Malone, M.D.
Title
President
Phone
(914) 582-4577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 203323 NY Primary

Addresses

Primary practice location

1800 Clove Rd
Staten Island, NY 10304-1616

Mailing address

25 Beechmont PL
New Rochelle, NY 10804-4509
Phone (914) 582-4577

Other identifiers 1

IdentifierTypeStateIssuer
02090664MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1316250012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BEECHMONT PL",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108044509",
            "telephone_number": "914-582-4577",
            "fax_number": "914-235-9564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041616",
            "telephone_number": "914-582-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY ANESTHESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-582-4577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "203323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02090664",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.