Active NPI
Deborah Serani, PSY.D.
- Psychologist
- Smithtown, NY
National Provider Identifier
1659516276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 010093
- Practice address
- 12 Ivy Hill Dr
Smithtown, NY 11787-4004 - Phone
- (631) 366-4674
- NPI assigned
- Dec 10, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 010093 | NY | Primary |
Addresses
Primary practice location
12 Ivy Hill Dr
Smithtown, NY 11787-4004
Mailing address
12 Ivy Hill Dr
Smithtown, NY 11787-4004
Phone (631) 366-4674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 1, 2021 through Mar 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228867200000",
"number": "1659516276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 IVY HILL DR",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874004",
"telephone_number": "631-366-4674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 IVY HILL DR",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117874004",
"telephone_number": "631-366-4674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERANI",
"first_name": "DEBORAH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-10",
"last_updated": "2008-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "010093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.