Provider Demographics
NPI:1154819191
Name:WECHSLER, SEREN (MS, RD, CDN)
Entity type:Individual
Prefix:MR
First Name:SEREN
Middle Name:
Last Name:WECHSLER
Suffix:
Gender:M
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3408 N DEERFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1914
Mailing Address - Country:US
Mailing Address - Phone:914-374-6819
Mailing Address - Fax:
Practice Address - Street 1:3408 N DEERFIELD AVE
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1914
Practice Address - Country:US
Practice Address - Phone:914-374-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86062441133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered