Provider Demographics
NPI:1215021522
Name:SEN, PIYALI (MD)
Entity Type:Individual
Prefix:
First Name:PIYALI
Middle Name:
Last Name:SEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PIYALI
Other - Middle Name:
Other - Last Name:RAY-SEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-7887
Mailing Address - Fax:631-454-4163
Practice Address - Street 1:9016 SUTPHIN BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-3636
Practice Address - Country:US
Practice Address - Phone:718-523-5500
Practice Address - Fax:718-658-8260
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218017207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02166329Medicaid
NY02166329Medicaid
NY0105KGMedicare Oscar/Certification