Provider Demographics
NPI:1548510159
Name:SERRIES, USFORD
Entity type:Individual
Prefix:
First Name:USFORD
Middle Name:
Last Name:SERRIES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3305
Mailing Address - Country:US
Mailing Address - Phone:347-558-8448
Mailing Address - Fax:347-554-8791
Practice Address - Street 1:1443 E 54TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3305
Practice Address - Country:US
Practice Address - Phone:347-558-8448
Practice Address - Fax:347-554-8791
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT63185833347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle