1790074219 NPI number — VINCENT JOHN SENA, MD

Table of content: (NPI 1790074219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790074219 NPI number — VINCENT JOHN SENA, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VINCENT JOHN SENA, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1790074219
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
165 NORTH VILLAGE AVENUE
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
ROCKVILLE CENTRE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-766-5881
Provider Business Mailing Address Fax Number:
516-594-0726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
165 NORTH VILLAGE AVENUE
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
ROCKVILLE CENTRE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-766-5881
Provider Business Practice Location Address Fax Number:
516-594-0726
Provider Enumeration Date:
04/05/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SENA
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
M.D. (OWNER)
Authorized Official Telephone Number:
516-766-5881

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  158697 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01835125 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com