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Individual

DR. JOSE I SERRUYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.P.C.

Contact information

Practice address
6907 43RD AVE, SUITE C 2, WOODSIDE, NY 11377-9100
(718) 830-3772
(718) 255-1841
Mailing address
6907 43RD AVE, SUITE C 2, WOODSIDE, NY 11377-9100
(718) 830-3772
(718) 255-1841

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
207927
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02104103
NY
Enumeration date
12/06/2005
Last updated
03/05/2009
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