Individual
DR. PAUL S HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Mailing address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
194397-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083812
GHI HMO
—
01
—
000405106001
BLUE SHIELD
—
01
—
000405106003
BLUE SHIELD NENY
—
05
—
01462151
—
NY
01
—
040426006651
FIDELIS
—
01
—
05311
MVP
—
01
—
10000873
CDPHP
—
01
—
110160500
US DEPT OF LABOR
—
01
—
12280
EMPIRE BLUE CROSS
—
01
—
194397-1
TRICARE NORTH REGION
—
01
—
33588R
FIDELIS MEDICARE
—
01
—
9707078
GHI
—
01
—
CAN1943976
WORKERS COMP
—
01
—
F77141
AMERICAN PROGRESSIVE TODA
—
01
—
PH01228010
EMPIRE BLUE CROSS
—
01
—
PH01228020
EMPIRE BLUE CROSS
—
Enumeration date
08/01/2005
Last updated
01/17/2017
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