Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | TE000943L | PA |
NPI | 1013137686 |
---|---|
Provider Name | Nadene Serano |
First Address | Coopersburg, PA 18036-1136 |
Second Address | Nazareth, PA 18064 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 09/07/2012 |