Basic Information
Provider Information
NPI: 1396894549
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SENOSIAIN
FirstName: JAVIER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 514 49TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112202010
CountryCode: US
TelephoneNumber: 7184375276
FaxNumber: 7184375239
Practice Location
Address1: 514 49TH ST
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112202010
CountryCode: US
TelephoneNumber: 7184375276
FaxNumber: 7184375239
Other Information
ProviderEnumerationDate: 01/09/2007
LastUpdateDate: 08/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804X235995NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
2084P0800X235995NYY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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