Active NPI
Jose Orlando Serrano, MHC
- Student in an Organized Health Care Education/Training Program
- New York, NY
National Provider Identifier
1376820878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- P79066
- Practice address
- 1841 Broadway
New York, NY 10023-7603 - Phone
- (212) 333-3444
- NPI assigned
- Nov 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | P79066 | NY | Primary |
Addresses
Primary practice location
1841 Broadway
New York, NY 10023-7603
Mailing address
3533 29TH St Apt D4
Long Island City, NY 11106-3129
Phone (787) 469-6619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P79066 | NY | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320969600000",
"number": "1376820878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3533 29TH ST APT D4",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111063129",
"telephone_number": "787-469-6619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1841 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100237603",
"telephone_number": "212-333-3444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERRANO",
"first_name": "JOSE",
"middle_name": "ORLANDO",
"credential": "MHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-11",
"last_updated": "2011-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "P79066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.