Healthcare Provider Details

I. General information

NPI: 1609875269
Provider Name (Legal Business Name): KENNETH D SENSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2005
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE.
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

P.O. BOX 632895
CINCINNATI OH
45263-2895
US

V. Phone/Fax

Practice location:
  • Phone: 513-872-2692
  • Fax: 513-872-1584
Mailing address:
  • Phone: 513-891-1006
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOH54004
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: