Jeffrey W Henderson, DO
Individual provider Active NPI Internal Medicine Physician · Ludlow, MA
NPI 1649354572 · NPPES record last updated Apr 7, 2008
Key facts
- NPI
- 1649354572
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 235262 (NY)
- Practice address
- 200 Center Street
Ludlow, MA 01056 - Phone
- (413) 589-7176
- Fax
- (413) 589-7710
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 235262 | NY | Yes |
| Internal Medicine Physician | 207R00000X | 234478 | MA |
Addresses
Primary practice location
200 Center Street
Ludlow, MA 01056
Mailing address
200 Center Street
Ludlow, MA 01056
Phone (413) 589-7176
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02685981 | Medicaid | NY |
Other providers in Ludlow, MA
- Jennifer M Gross
- Neil Grossman
- Hampden Podiatry Associates
- Hampden Podiatry Associates
- Suzanne Phillips Hangasky
- Home Safe Home LLC
- John R Hunt
- Heather Marie Hutchins
- Fernando Y Jayma
- James John Joyce
All providers in Ludlow, MA · Internal Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.