Provider Demographics
NPI:1326261876
Name:SENA, JENNY P (PA)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:P
Last Name:SENA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 OAK TREE AVE STE P
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5126
Mailing Address - Country:US
Mailing Address - Phone:908-205-0632
Mailing Address - Fax:908-205-0629
Practice Address - Street 1:904 OAK TREE AVE STE P
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5126
Practice Address - Country:US
Practice Address - Phone:908-205-0632
Practice Address - Fax:908-205-0629
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00028900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S64858Medicare UPIN