Mariah S Henderson, PA
Physician Assistant in Medford, Massachusetts
1104376904- Practice location
- 124 Professors Row, Medford, MA 02155-5816
- Phone
- 617-627-7947
- Fax
- —
- Last updated
- March 23, 2020
Mariah Swiech Henderson is a Physician Assistant based in Medford, MA. Mariah Swiech Henderson practices in Medford, MA and has the professional credentials of PA. The NPI Number for Mariah Swiech Henderson is 1104376904 and holds a License No. PA5908 (MA). The current practice location address for Mariah Swiech Henderson is 124 Professors Row, Medford, MA 02155-5816 and can be reached out via phone at 617-627-7947.
Provider Profile Details
- NPI Number
- 1104376904
- Provider Name
- Mariah Swiech Henderson
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 124 Professors Row, Medford, MA 02155-5816
- Phone Number
- 617-627-7947
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- October 5, 2016
- Last Update Date
- March 23, 2020
- Certification Date
- March 23, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 124 Professors Row
Medford, MA 02155-5816 - City
- Medford
- State
- Massachusetts
- Zip
- 02155-5816
- Phone Number
- 617-627-7947
Provider Business Mailing Address Details
- Address
- 124 Professors Row
Medford, MA 02155-5816 - City
- Medford
- State
- MA
- Zip
- 02155-5816
- Phone Number
- 617-627-7947
License Information
- License Number
- PA5908
- License State
- MA
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mariah S Henderson, PA?
The NPI number of Mariah S Henderson, PA is 1104376904. It was assigned on October 5, 2016 and is currently active in the NPPES registry.
What is the specialty of Mariah S Henderson, PA?
Mariah S Henderson, PA is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in MA under license number PA5908.
Where does Mariah S Henderson, PA practice?
The practice location is 124 Professors Row, Medford, MA 02155-5816. The office can be reached at 617-627-7947 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104376904 directly on the NPPES registry website.