Provider Demographics
NPI:1104854017
Name:SENALL, JOSEPH M (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:SENALL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116 FOX HUNT DR # 118
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-2535
Mailing Address - Country:US
Mailing Address - Phone:302-239-1933
Mailing Address - Fax:
Practice Address - Street 1:5301 LIMESTONE RD STE 128
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1253
Practice Address - Country:US
Practice Address - Phone:302-239-1933
Practice Address - Fax:302-239-1002
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3 1199152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU35684Medicare UPIN
DE012284SOSMedicare ID - Type Unspecified