Provider Demographics
NPI:1215904107
Name:SEN, RONALD P (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:P
Last Name:SEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:50 TREMONT ST
Mailing Address - Street 2:#109
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2721
Mailing Address - Country:US
Mailing Address - Phone:781-662-3310
Mailing Address - Fax:781-662-6403
Practice Address - Street 1:50 TREMONT ST
Practice Address - Street 2:#109
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2721
Practice Address - Country:US
Practice Address - Phone:781-662-3310
Practice Address - Fax:781-662-6403
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA74189207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3082393Medicaid
MAE89724Medicare UPIN
MA3082393Medicaid