Individual
JEFFREY W HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
200 CENTER STREET, LUDLOW, MA 01056
(413) 589-7176
(413) 589-7710
Mailing address
200 CENTER STREET, LUDLOW, MA 01056
(413) 589-7176
(413) 589-7710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
234478
MA
207R00000X
Internal Medicine Physician
Primary
235262
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02685981
—
NY
Enumeration date
10/25/2006
Last updated
04/07/2008
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