Provider Demographics
NPI:1326039603
Name:SENGHAS, ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:SENGHAS
Suffix:
Gender:F
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:CLEANSLATE CENTERS
Mailing Address - Street 2:244 MAIN STREET ANNEX PO BOX 32 ATTN ANITRA PIQUE
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01061-0032
Mailing Address - Country:US
Mailing Address - Phone:413-584-2173
Mailing Address - Fax:413-517-6009
Practice Address - Street 1:76B CARLON DR
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2373
Practice Address - Country:US
Practice Address - Phone:413-584-2178
Practice Address - Fax:413-586-4233
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA57444207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000008111OtherBMC HEALTHNET
MA484699OtherCONNECTICARE
MA101484OtherCIGNA
MA3700017421OtherMEDICARE RAILROAD
MAJ06291OtherBCBS OF MASS
MA057444OtherTUFTS
MA7166124OtherAETNA
MA16315OtherHEALTH NEW ENGLAND
MA201187OtherHARVARD PILGRIM HEALTHCAR
MA3027546Medicaid
MA000000008111OtherBMC HEALTHNET
MA16315OtherHEALTH NEW ENGLAND