Provider Demographics
NPI:1164442091
Name:HENDRA, KATHERINE P (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:P
Last Name:HENDRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:77 WARREN ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3601
Mailing Address - Country:US
Mailing Address - Phone:617-789-2545
Mailing Address - Fax:617-789-2893
Practice Address - Street 1:77 WARREN ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3601
Practice Address - Country:US
Practice Address - Phone:617-789-2545
Practice Address - Fax:617-789-2893
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-09-17
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Provider Licenses
StateLicense IDTaxonomies
MA76928207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine