Individual
ALICIA HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD451063
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD451063
PA
208000000X
Pediatrics Physician
MD451063
PA
Other
Enumeration date
06/06/2011
Last updated
06/02/2023
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