Basic Information
| Provider Information | |||||||||
| NPI: | 1962014621 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGAN | ||||||||
| FirstName: | SERENA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 240 CETRONIA RD | ||||||||
| Address2: | |||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181049263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845034500 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 ST LUKES BLVD | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180455671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845034500 | ||||||||
| FaxNumber: | 4845034501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2020 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | MA00000 | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363AM0700X | MA061907 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.