Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 022850 | NY |
Y | 103T00000X | Psychologist | 022850 | NY |
NPI | 1013679083 |
---|---|
Provider Name | Dr. Danielle Seraile |
First Address | New York, NY 10030-2411 |
Second Address | Southampton, NY 11968-3617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2021 |
Last Update Date | 07/10/2021 |