Back Bay MD LLC
NPI #1972460244 in Malden, Massachusetts
Provider Information
- NPI Number
- 1972460244
- Entity Type
- Organization
- Organization Name
- Back Bay MD LLC
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Jan 7, 2026
- Last Updated
- Jan 7, 2026
Practice Location
- Address
- 578 MAIN ST UNIT B5
- City
- Malden
- State
- Massachusetts
- ZIP Code
- 02148-4094
- Phone
- (857) 200-8997
Authorized Official
- Name
- DR. LUIS HENKEL, MD
- Title
- OWNER AND MEDICAL DIRECTOR
- Phone
- (857) 200-8997
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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