MEDICARE: SHRIMATTI DASS SENAUTH I

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	101200000X	Drama Therapist		NY

General Provider Information

NPI Number	:	1780527127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHRIMATTI DASS SENAUTH I

Provider Business Mailing Address
First Line	:	184 RIDGEWOOD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1232
Country	:	US
Telephone Number	:	516-308-4966
Fax Number	:	516-590-7573

Provider Business Practice Location Address
First Line	:	184 RIDGEWOOD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-1232
Country	:	US
Telephone Number	:	516-308-4966
Fax Number	:	516-590-7573

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ SHRIMATTI DASS SENAUTH I ” Practice Location

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