MEDICARE: NINA E SENADOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	042744	NY

General Provider Information

NPI Number	:	1669786505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA E SENADOS

Provider Business Mailing Address
First Line	:	6011 BROADWAY APT 2V
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6011 BROADWAY APT 2V
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2110
Country	:	US
Telephone Number	:	718-274-1421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2010
Last Update Date	:	08/03/2010

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Directions to “ NINA E SENADOS ” Practice Location

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