Provider Demographics
NPI:1811915697
Name:SENA, VINCENT JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:JOHN
Last Name:SENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERRICK RD STE 102E
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4832
Mailing Address - Country:US
Mailing Address - Phone:516-766-5881
Mailing Address - Fax:516-594-0726
Practice Address - Street 1:100 MERRICK RD STE 102E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4832
Practice Address - Country:US
Practice Address - Phone:516-766-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158697208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64420Medicare UPIN