Provider Demographics
NPI:1902988348
Name:SERINI, DANIELLE MICHELE (DC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MICHELE
Last Name:SERINI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 SLOSSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314
Mailing Address - Country:US
Mailing Address - Phone:718-727-0111
Mailing Address - Fax:718-921-0168
Practice Address - Street 1:272 SLOSSON AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314
Practice Address - Country:US
Practice Address - Phone:718-727-0111
Practice Address - Fax:718-921-0168
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0109381111N00000X
NJ38MC00637200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC109381BOtherWORKERS COMPENSATION
NYP3624777OtherOXFORD
NYX01J21Medicare ID - Type Unspecified
V07125Medicare UPIN