Provider Demographics
NPI:1306376934
Name:HENDERSON, ELISABETH CATHERINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:CATHERINE
Last Name:HENDERSON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:3757 CARMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5438
Practice Address - Country:US
Practice Address - Phone:518-355-7063
Practice Address - Fax:518-357-0646
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-13
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
NY020892363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant