Provider Demographics
NPI:1336562271
Name:SENAN, HISHAM (DPT)
Entity Type:Individual
Prefix:
First Name:HISHAM
Middle Name:
Last Name:SENAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 SHORE PKWY APT 6H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6114
Mailing Address - Country:US
Mailing Address - Phone:347-465-6506
Mailing Address - Fax:
Practice Address - Street 1:1429 SHORE PKWY APT 6H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6114
Practice Address - Country:US
Practice Address - Phone:347-465-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist