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Individual

DR. HENRY Y TY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
354 MERRIMACK ST, LAWRENCE, MA 01843-1754
(978) 687-2321
(978) 685-7265
Mailing address
354 MERRIMACK ST, LAWRENCE, MA 01843-1754
(978) 687-2321
(978) 685-7265

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
12042
NH
207T00000X
Neurological Surgery Physician
Primary
218030
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0030531
NHP
MA
01
01Y007853MA01
ANTHEM
NH
01
05-00833
EVERCARE
MA
01
05-00938
UHC
MA
05
2020670
MA
05
30203970
NH
01
467235
THP
MA
01
59840
FCHP
MA
01
7456469
AETNA
MA
01
7960842-001
CIGNA
MA
01
AA1709
HPHC
MA
01
J26789
BCBS
MA
Enumeration date
10/03/2005
Last updated
03/04/2020
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