Provider Demographics
NPI:1912447582
Name:DESENA, ROBERTO (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:DESENA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20680 SENECA MEADOWS PKWY STE 213
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-7029
Mailing Address - Country:US
Mailing Address - Phone:717-658-1928
Mailing Address - Fax:
Practice Address - Street 1:20680 SENECA MEADOWS PKWY STE 213
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7029
Practice Address - Country:US
Practice Address - Phone:717-658-1928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor