Provider Demographics
NPI:1366458499
Name:SEN, CHANDRANATH (MD)
Entity type:Individual
Prefix:
First Name:CHANDRANATH
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:PO BOX 415794
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5794
Mailing Address - Country:US
Mailing Address - Phone:212-263-5333
Mailing Address - Fax:
Practice Address - Street 1:550 1ST AVE FL HCC3
Practice Address - Street 2:SUITE 3F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-5333
Practice Address - Fax:212-263-5733
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1878471207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01308878Medicaid
NY01308878Medicaid
C34511Medicare UPIN