Provider Demographics
NPI:1861543753
Name:SENCION, SERGIO MANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:SERGIO
Middle Name:MANUEL
Last Name:SENCION
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 1:400 FORT WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6849
Mailing Address - Country:US
Mailing Address - Phone:212-923-8500
Mailing Address - Fax:212-923-6718
Practice Address - Street 1:400 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6849
Practice Address - Country:US
Practice Address - Phone:212-923-8500
Practice Address - Fax:212-923-6718
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098338208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00167400Medicaid
NYA40696OtherPEDIATRICIAN