Organization
BACK BAY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS HENKEL MD (OWNER AND MEDICAL DIRECTOR)
(857) 200-8997
Entity
Organization
Contact information
Practice address
578 MAIN ST UNIT B5, MALDEN, MA 02148-4094
(857) 200-8997
Mailing address
578 MAIN ST UNIT B5, MALDEN, MA 02148-4094
(857) 200-8997
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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