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General NPI Number Information
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NPI Number | 1164527107
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Entity Type | Individual
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Provider Name | DOUGLAS MARK SENDEROFF MD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 90 S RIDGE ST LL-7
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City | RYE BROOK
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State | NY
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Zip | 10573-2867
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Country | US
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Telephone | 914-934-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 400 E 56TH ST 10P
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City | NEW YORK
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State | NY
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Zip | 10022-4147
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Country | US
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Telephone | 212-753-7608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 183561
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License Number State | NY
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