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General NPI Number Information
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NPI Number | 1396730669
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Entity Type | Individual
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Provider Name | SANDRA N SENESHEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 301 GORDON GUTMANN BLVD SUITE 401
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3764
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Country | US
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Telephone | 812-282-0637
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Fax | 812-283-6330
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Provider Business Mailing Address
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Address Line | PO BOX 776351 SUITE 401
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-559-9337
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Fax | 502-272-5339
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01053197A
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License Number State | IN
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