Provider Demographics
NPI:1134195639
Name:HENEY, NIALL MERCER (MB MD)
Entity type:Individual
Prefix:DR
First Name:NIALL
Middle Name:MERCER
Last Name:HENEY
Suffix:
Gender:M
Credentials:MB MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT STREET GRB 1102
Practice Address - Street 2:DEPARTMENT OF UROLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-3011
Practice Address - Fax:617-726-6131
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA37668208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA037668OtherTUFTS HEALTH PLAN
MA2029766Medicaid
MAM08844OtherBCBS MA
MAM08844OtherBCBS MA
MA037668OtherTUFTS HEALTH PLAN