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Organization
BACK BAY MD LLC
Active
Organization
BACK BAY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS HENKEL MD (OWNER AND MEDICAL DIRECTOR)
(857) 200-8997
Entity
Organization
Contact information
Practice address
578 MAIN ST UNIT B5, MALDEN, MA 02148-4094
(857) 200-8997
Mailing address
578 MAIN ST UNIT B5, MALDEN, MA 02148-4094
(857) 200-8997
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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