MR. STEPHEN SENENKO (NPI# 1164784542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164784542 |
Entity Type | Individual |
Full Name | MR. STEPHEN SENENKO |
Credential | PA-C |
Practice Address |
739 Irving Ave Ste 200 Syracuse NY 13210 |
Mailing Address |
739 Irving Ave Ste 200 Syracuse NY 13210-1668 |
Practice Telephone | 3154795070 |
Practice Fax Number | 3157012525 |
Mailing Telephone | 3154795070 |
Mailing Fax Number | 3157012525 |
Enumeration Date | 2012-06-12 |
Last Update Date | 2019-06-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 133V00000X | Dietitian, Registered | 007505-1 | NY | Dietary & Nutritional Service Providers |
N | 363A00000X | Physician Assistant | 020247 | Physician Assistants & Advanced Practice Nursing Providers | |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
020247 | NY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | STATE OF NEW YORK EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS | 020247 | 01 |
NY | UNIVERSITY OF THE STATE OF NEW YORK EDUCATION DEPARTMENT OFFICE | 007505-1 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
921 State St, Ogdensburg, NY 13669 | 3153939268 |
Street Address |
739 IRVING AVE STE 200 |
City | SYRACUSE |
State | NY |
Zip Code | 13210 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356407993 | Internist Associates of Central New York PC | Durable Medical Equipment & Medical Supplies | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2006-12-28 |
1467070490 | Danielle L Ryan | Nurse Practitioner | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2020-07-07 |
1720642184 | Erika Johnson | Physician Assistant | 739 Irving Ave Ste 200, Syracuse, NY 13210 | 2019-04-30 |
1801382338 | Emily Anne Weston | Nurse Practitioner | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2018-07-09 |
1629526033 | Dipendra P Sah | Physician Assistant | 739 Irving Ave Ste 200, Syracuse, NY 13210 | 2016-09-14 |
1558721373 | Amira Goldberg | Nurse Practitioner | 739 Irving Ave Ste 200, Syracuse, NY 13210 | 2016-03-07 |
1205275732 | Parifar Rostami | Internal Medicine | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2013-06-18 |
1801149737 | Brittney Beverly Pfohl | Nurse Practitioner | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2012-10-16 |
1952629487 | Michele Alphonse | Internal Medicine | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2010-05-07 |
1689837734 | David Jonathan Di Cesar | Internal Medicine | 739 Irving Ave Ste 200, Syracuse, NY 13210-1668 | 2008-07-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
Find all providers in zip 13210 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
1760043574 | Colin Michael King | Physician Assistant | 135 Somerset Rd, Syracuse, NY 13224-1961 | 2019-06-24 |
1346657251 | Jessica Lynn Demauro | Physician Assistant | 111 Waverly Avenue, Syracuse, NY 13244 | 2014-07-14 |
1982664876 | Vincent M. Gemelli | Physician Assistant | 1304 Buckley Road, Suite 302, Syracuse, NY 13212-4318 | 2006-03-24 |
1245210129 | Benjamin I Connor | Physician Assistant | 2700 Court St, Syracuse, NY 13208-3295 | 2006-01-18 |
1326020033 | Michelle Margaret Ederer | Physician Assistant | 3504 W Genesee St, Syracuse, NY 13219-2008 | 2005-11-17 |
1689672230 | Robert D Kirk | Physician Assistant | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1892 | 2005-07-08 |
1992702278 | Michael P Sharak | Physician Assistant | 90 Presidential Plz, Firm B, Syracuse, NY 13202-2240 | 2005-07-01 |
1568022853 | Chelsea Clareann Yager | Physician Assistant | 301 Prospect Ave, Syracuse, NY 13203-1807 | 2019-06-18 |
1104308253 | Diana Maria Ramirez | Physician Assistant | 750 E Adams St, Syracuse, NY 13210-2306 | 2018-09-05 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.