Provider Demographics
NPI:1467754879
Name:SENBERTRAND, MICHELE (NP)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SENBERTRAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GRACE CT
Mailing Address - Street 2:5M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4184
Mailing Address - Country:US
Mailing Address - Phone:917-817-1146
Mailing Address - Fax:718-858-9617
Practice Address - Street 1:2 GRACE CT
Practice Address - Street 2:5M
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4184
Practice Address - Country:US
Practice Address - Phone:917-817-1146
Practice Address - Fax:718-858-9617
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305461-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health