Serenity Zone LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

074680 Issued in NY

Legal business name

SERENITY ZONE LCSW PLLC

Practice address

4025 Austin Blvd
Island Park, NY 11558-1221

Phone

(516) 432-1790

Fax

(516) 432-0760

NPI assigned

Sep 29, 2016

Organization subpart

No

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

Authorized official

Name

Jeff Cornatzor

Title

Secretary

Phone

(516) 432-1790

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Serenity Zone LCSW PLLC

  • Clinical Social Worker
  • Island Park, NY
  • NPI 1154766350

  O20161018000389

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sahra Y Robinson, LCSW

  • Clinical Social Worker
  • Island Park, NY
  • NPI 1467707810
  NPD

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1457800534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 AUSTIN BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581221",
            "telephone_number": "516-432-1790",
            "fax_number": "516-432-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 AUSTIN BLVD",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115581221",
            "telephone_number": "516-432-1790",
            "fax_number": "516-432-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY ZONE LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "CORNATZOR",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "516-432-1790"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg P Saggio, D.O.
• Nidhin Samuel
• Steven Schrank, DPT
• Seaside Physical Therapy P.C. (Peak Performance Physical Therapy)
• Serenity Zone LCSW PLLC
• Robert Serwetz, M. ED.
• Sheila Peck
• Solo Care
• Conchita Solomon, OTR/L
• South Island Family Medical, LLC (South Island Medical)

• Clinical Social Worker in Island Park, NY
• Providers in Island Park, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.