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General NPI Number Information
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NPI Number | 1851523195
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Entity Type | Individual
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Provider Name | GUNJAN MALIK SENAPATI M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 07/15/2014
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Provider Practice Location Address
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Address Line | 17 OTIS ST D105
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City | CAMBRIDGE
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State | MA
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Zip | 02141-1842
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Country | US
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Telephone | 248-515-7890
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Fax |
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Provider Business Mailing Address
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Address Line | 17 OTIS ST D105
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City | CAMBRIDGE
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State | MA
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Zip | 02141-1842
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Country | US
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Telephone | 248-515-7890
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125056230
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License Number State | IL
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