Provider Demographics
NPI:1194739847
Name:SEN, DILIP (MD)
Entity type:Individual
Prefix:
First Name:DILIP
Middle Name:
Last Name:SEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 DERBY ST
Mailing Address - Street 2:
Mailing Address - City:EAST WILLISTON
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1408
Mailing Address - Country:US
Mailing Address - Phone:516-739-1939
Mailing Address - Fax:
Practice Address - Street 1:6 SUTTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3838
Practice Address - Country:US
Practice Address - Phone:718-756-1355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144837207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4485Medicare UPIN
NYD1D81Medicare ID - Type Unspecified