Provider Demographics
NPI:1912003294
Name:SEN, ANUBHA (MD)
Entity Type:Individual
Prefix:
First Name:ANUBHA
Middle Name:
Last Name:SEN
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 1:460 A CANISTEO ST
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-2154
Mailing Address - Country:US
Mailing Address - Phone:607-324-0321
Mailing Address - Fax:607-324-1542
Practice Address - Street 1:460 A CANISTEO ST
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-2154
Practice Address - Country:US
Practice Address - Phone:607-324-0321
Practice Address - Fax:607-324-1542
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY126678207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMDA058OtherPREFERRED CARE
NY0061189Medicaid
NYPO10126678OtherBLUE CHOICE
NY39816BMedicare ID - Type Unspecified
NY0061189Medicaid