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Individual

TIMOTHY J HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1055 HAMBURG TPKE STE 2, WAYNE, NJ 07470
(973) 616-0200
(973) 616-1792
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
52523
GA
207X00000X
Orthopaedic Surgery Physician
A92330
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
25MA09165800
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
25MA09165800
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
271409-1
NY

Other

Enumeration date
04/26/2006
Last updated
12/29/2020
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