Healthcare Provider Details

I. General information

NPI: 1942230859
Provider Name (Legal Business Name): SENAIT DYSON M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 N BEVERLY AVE STE 101
TUCSON AZ
85712-2155
US

IV. Provider business mailing address

2141 N BEVERLY AVE STE 101
TUCSON AZ
85712-2155
US

V. Phone/Fax

Practice location:
  • Phone: 520-838-0777
  • Fax: 520-838-0669
Mailing address:
  • Phone: 520-838-0777
  • Fax: 520-838-0669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA90945
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberA90945
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: