Provider Demographics
NPI:1831381821
Name:SENATUS, PATRICK B (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:B
Last Name:SENATUS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2800 TAMARACK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5539
Mailing Address - Country:US
Mailing Address - Phone:860-648-4480
Mailing Address - Fax:860-648-2132
Practice Address - Street 1:2800 TAMARACK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5539
Practice Address - Country:US
Practice Address - Phone:860-648-4480
Practice Address - Fax:860-648-2132
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT045726207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001457292Medicaid
CT140000223Medicare PIN