| Back Bay Md Llc | |
|
578 Main St Unit B5 Malden MA 02148-4094 | |
| (857) 200-8997 | |
| Not Available |
| Full Name | Back Bay Md Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 578 Main St Unit B5, Malden, Massachusetts |
| Authorized Official Name and Position | Luis Henkel (OWNER AND MEDICAL DIRECTOR) |
| Authorized Official Contact | 8572008997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Back Bay Md Llc 578 Main St Unit B5 Malden MA 02148-4094 Ph: (857) 200-8997 | Back Bay Md Llc 578 Main St Unit B5 Malden MA 02148-4094 Ph: (857) 200-8997 |
| NPI Number | 1972460244 |
|---|---|
| Provider Enumeration Date | 01/07/2026 |
| Last Update Date | 01/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972460244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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