1215673579 NPI number — MR. DIOGO RIBEIRO DE SENE M.D.

Table of content: MR. DIOGO RIBEIRO DE SENE M.D. (NPI 1215673579)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215673579 NPI number — MR. DIOGO RIBEIRO DE SENE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIBEIRO DE SENE
Provider First Name:
DIOGO
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1215673579
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/23/2023
NPI Reactivation Date:
05/10/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 IRVING ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-877-2835
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 IRVING ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-877-2835
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/10/2022

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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