Provider Demographics
NPI:1982403085
Name:SERRA DIABETICS LLC
Entity type:Organization
Organization Name:SERRA DIABETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-819-8548
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:NORTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10560-0022
Mailing Address - Country:US
Mailing Address - Phone:914-819-8548
Mailing Address - Fax:
Practice Address - Street 1:56 JUNE RD STE 201
Practice Address - Street 2:
Practice Address - City:NORTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10560-1702
Practice Address - Country:US
Practice Address - Phone:914-819-8548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies