Individual
DR. SANDRA N SENESHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 GORDON GUTMANN BLVD, SUITE 401, JEFFERSONVILLE, IN 47130-3764
(812) 282-0637
(812) 283-6330
Mailing address
PO BOX 776351 SUITE 401, CHICAGO, IL 60677-6351
(502) 559-9337
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01053197A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01053197A
STATE ID #
IN
01
—
01053197B
CONTROLLED SUBSTANCE REG
IN
01
—
196290271
MEDICARE
IN
05
—
200267780
—
IN
05
—
200267780A
—
IN
05
—
7100447830
—
KY
Enumeration date
09/13/2005
Last updated
04/05/2024
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