Provider Demographics
NPI:1285781484
Name:SERENARI, MICHAEL PAUL (CO, BOCO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PAUL
Last Name:SERENARI
Suffix:
Gender:M
Credentials:CO, BOCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 ROSTRAVER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1967
Mailing Address - Country:US
Mailing Address - Phone:724-350-0457
Mailing Address - Fax:724-930-8545
Practice Address - Street 1:638 ROSTRAVER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1967
Practice Address - Country:US
Practice Address - Phone:724-930-8544
Practice Address - Fax:724-930-8545
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist