Healthcare Provider Details

I. General information

NPI: 1679012389
Provider Name (Legal Business Name): SENCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10410 KENSINGTON PKWY SUITE 302
KENSINGTON MD
20895-2943
US

IV. Provider business mailing address

10410 KENSINGTON PKWY SUITE 302
KENSINGTON MD
20895-2943
US

V. Phone/Fax

Practice location:
  • Phone: 240-988-8106
  • Fax:
Mailing address:
  • Phone: 240-988-8106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SOKHNA DIOP
Title or Position: CEO
Credential: BSN, IBCLC, MT
Phone: 240-988-8106