Provider Demographics
NPI:1427162049
Name:SERRANO, EMMA RITA (MD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:RITA
Last Name:SERRANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5480 WOLFE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-3232
Mailing Address - Country:US
Mailing Address - Phone:412-653-4327
Mailing Address - Fax:
Practice Address - Street 1:1601 MAYVIEW RD
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1547
Practice Address - Country:US
Practice Address - Phone:412-257-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036952L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA665452Medicare ID - Type Unspecified
PAE-80437Medicare UPIN