Provider Demographics
NPI:1487470340
Name:SERENITY NP IN PSYCHIATRY SERVICES PLLC
Entity type:Organization
Organization Name:SERENITY NP IN PSYCHIATRY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NNEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MBADIWE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:302-521-6128
Mailing Address - Street 1:3336 FULTON ST UNIT 29
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-2004
Mailing Address - Country:US
Mailing Address - Phone:302-521-6128
Mailing Address - Fax:
Practice Address - Street 1:42 BROADWAY FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1617
Practice Address - Country:US
Practice Address - Phone:646-347-6935
Practice Address - Fax:646-974-8309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-25
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty