Healthcare Provider Details

I. General information

NPI: 1215984968
Provider Name (Legal Business Name): SABYASACHI SEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/14/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 M ST NW FL 6
WASHINGTON DC
20037-1434
US

IV. Provider business mailing address

9916 HARROGATE RD
BETHESDA MD
20817-1504
US

V. Phone/Fax

Practice location:
  • Phone: 202-994-8560
  • Fax:
Mailing address:
  • Phone: 301-461-6676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number225981
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: