1881767390 NPI number — DR. KAREN SENESE MD

Table of content: DR. KAREN SENESE MD (NPI 1881767390)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881767390 NPI number — DR. KAREN SENESE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SENESE
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881767390
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
520 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMS RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08753-7444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-557-4147
Provider Business Mailing Address Fax Number:
732-557-4147

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOMS RIVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08753-7444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-557-4147
Provider Business Practice Location Address Fax Number:
732-557-4147
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0804X , with the licence number:  MA67729 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007274403 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 228492 . This is a "MHN PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 279741000 . This is a "AMERIHEALTH PROVIDER NUMB" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2032377000 . This is a "AMERIHEALTH PPO PROVIDER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 214099000 . This is a "MAGELLAN PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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