Healthcare Provider Details

I. General information

NPI: 1912003294
Provider Name (Legal Business Name): ANUBHA SEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 A CANISTEO ST
HORNELL NY
14843-2154
US

IV. Provider business mailing address

460 A CANISTEO ST
HORNELL NY
14843-2154
US

V. Phone/Fax

Practice location:
  • Phone: 607-324-0321
  • Fax: 607-324-1542
Mailing address:
  • Phone: 607-324-0321
  • Fax: 607-324-1542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number126678
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: