Provider Demographics
NPI:1790170579
Name:SENTER, ROSS MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:MICHAEL
Last Name:SENTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4010
Mailing Address - Country:US
Mailing Address - Phone:718-627-8700
Mailing Address - Fax:718-627-2783
Practice Address - Street 1:440 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223
Practice Address - Country:US
Practice Address - Phone:718-627-8700
Practice Address - Fax:718-627-2783
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NYN006940-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program