Provider Demographics
NPI:1720886799
Name:SUWARNA, SERENA
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:
Last Name:SUWARNA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6835 VELVET HORN
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-4354
Mailing Address - Country:US
Mailing Address - Phone:216-789-4456
Mailing Address - Fax:
Practice Address - Street 1:6835 VELVET HORN
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-4354
Practice Address - Country:US
Practice Address - Phone:216-789-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty