Provider Demographics
NPI:1316757198
Name:SERRANO, NICHOLAS A (MA)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:A
Last Name:SERRANO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TOWN HOUSE PL APT 1H
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK PLAZA
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3219
Mailing Address - Country:US
Mailing Address - Phone:516-498-1778
Mailing Address - Fax:
Practice Address - Street 1:1 TOWN HOUSE PL APT 1H
Practice Address - Street 2:
Practice Address - City:GREAT NECK PLAZA
Practice Address - State:NY
Practice Address - Zip Code:11021-3219
Practice Address - Country:US
Practice Address - Phone:516-498-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor