Provider Demographics
NPI:1851523195
Name:SENAPATI, GUNJAN MALIK (MD)
Entity Type:Individual
Prefix:MRS
First Name:GUNJAN
Middle Name:MALIK
Last Name:SENAPATI
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 1:17 OTIS ST
Mailing Address - Street 2:D105
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1842
Mailing Address - Country:US
Mailing Address - Phone:248-515-7890
Mailing Address - Fax:
Practice Address - Street 1:17 OTIS ST
Practice Address - Street 2:D105
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1842
Practice Address - Country:US
Practice Address - Phone:248-515-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125056230207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine