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General NPI Number Information
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NPI Number | 1699730846
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Entity Type | Organization
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Legal Business Name | FSS PSYCHIATRIC, LLC
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8629 BLUEJACKET ST SUITE 102
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City | LENEXA
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State | KS
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Zip | 66214-1604
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Country | US
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Telephone | 913-677-0500
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Fax | 913-677-5243
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Provider Business Mailing Address
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Address Line | PO BOX 674
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City | SHAWNEE MISSION
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State | KS
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Zip | 66201-0674
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Country | US
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Telephone | 913-248-9693
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Fax | 913-248-9383
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Authorized Official
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Title or Position | PRINCIPAL
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Name | SANDIP SEN
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Credential | MD
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Telephone | 913-677-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 04-21059
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License Number State | KS
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