Provider Demographics
NPI:1912586330
Name:SENRA, CLEIFORD (MD, MPH, MS)
Entity type:Individual
Prefix:DR
First Name:CLEIFORD
Middle Name:
Last Name:SENRA
Suffix:
Gender:M
Credentials:MD, MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:WESTHAMPTON BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11978-2331
Mailing Address - Country:US
Mailing Address - Phone:631-953-4500
Mailing Address - Fax:631-953-4570
Practice Address - Street 1:131 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:WESTHAMPTON BEACH
Practice Address - State:NY
Practice Address - Zip Code:11978-2331
Practice Address - Country:US
Practice Address - Phone:631-953-4500
Practice Address - Fax:631-953-4570
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332388207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine