Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 59802 | MN |
Y | 204F00000X | Transplant Surgeon | 61502 | CT |
NPI | 1003960626 |
---|---|
Provider Name | Oscar Kenneth Serrano |
First Address | Minneapolis, MN 55455-4800 |
Second Address | Hartford, CT 06106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 02/08/2018 |