Healthcare Provider Details

I. General information

NPI: 1770564817
Provider Name (Legal Business Name): CAMILLE SENZAMICI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQUARE EAST
NEW YORK NY
10003
US

IV. Provider business mailing address

PO BOX 32889
HARTFORD CT
06150
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8326
  • Fax:
Mailing address:
  • Phone: 212-256-3539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number190079
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: