| Serenity Zone Lcsw Pllc | |
|
4025 Austin Blvd Island Park NY 11558-1221 | |
| (516) 432-1790 | |
| (516) 432-0760 |
| Full Name | Serenity Zone Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4025 Austin Blvd, Island Park, New York |
| Authorized Official Name and Position | Jeff Cornatzor (SECRETARY) |
| Authorized Official Contact | 5164321790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Serenity Zone Lcsw Pllc 4025 Austin Blvd Island Park NY 11558-1221 Ph: (516) 432-1790 | Serenity Zone Lcsw Pllc 4025 Austin Blvd Island Park NY 11558-1221 Ph: (516) 432-1790 |
| NPI Number | 1154766350 |
|---|---|
| Provider Enumeration Date | 05/02/2013 |
| Last Update Date | 06/20/2016 |
| Medicare PECOS PAC ID | 7618265042 |
|---|---|
| Medicare Enrollment ID | O20161018000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154766350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 074680-1 (New York) | Primary |
| Provider Name | Sahra Y Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467707810 PECOS PAC ID: 8527216233 Enrollment ID: I20120920000530 |
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Serenity Zone Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4025 Austin Blvd, Island Park, NY 11558 Phone: 516-432-1790 Fax: 516-432-0760 | |
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