Provider Demographics
NPI:1154850618
Name:SENCHAK, JORDAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:JOSEPH
Last Name:SENCHAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-831-1320
Mailing Address - Fax:412-831-9748
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-831-1320
Practice Address - Fax:412-831-9748
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT213791207R00000X
PAMD469133207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD469133Medicaid
PAMT213791Medicaid