Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 179375 | NY |
Y | 207RN0300X | Nephrologist | 25MA10750100 | NJ |
NPI | 1023070851 |
---|---|
Provider Name | Dr. David Serur |
First Address | Hackensack, NJ 07601-1997 |
Second Address | Hackensack, NJ 07601-1941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01467069 | (05) | NM |
F20811 | (02) | NY |