Provider Demographics
NPI:1144596784
Name:SEN, LILIA F (MD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:F
Last Name:SEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILIA
Other - Middle Name:F
Other - Last Name:SHAMMASSOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3815 S. VAL VISTA DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-7309
Mailing Address - Country:US
Mailing Address - Phone:480-782-0993
Mailing Address - Fax:855-329-8939
Practice Address - Street 1:6565 E CARONDELET DR STE 300
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2158
Practice Address - Country:US
Practice Address - Phone:520-545-0608
Practice Address - Fax:520-795-0354
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51677207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ200728Medicaid
AZ200728Medicaid