Provider Demographics
NPI:1235300179
Name:ANINDYA KUMAR SEN
Entity Type:Organization
Organization Name:ANINDYA KUMAR SEN
Other - Org Name:EAST TENNESSEE HEMATOLOGY/ONCOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDGELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-787-7080
Mailing Address - Street 1:1406 TUSCULUM BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4332
Mailing Address - Country:US
Mailing Address - Phone:423-787-7080
Mailing Address - Fax:423-787-7087
Practice Address - Street 1:110 CORPORATE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2008
Practice Address - Country:US
Practice Address - Phone:423-282-0543
Practice Address - Fax:423-282-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000021891207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3376478Medicaid
TN4034320OtherBLUE CROSS BLUE SHIELD
TN4034320OtherBLUE CROSS BLUE SHIELD