Provider Demographics
NPI:1194513432
Name:BAINS, HENRIETTA J (MD, PHD)
Entity type:Individual
Prefix:MRS
First Name:HENRIETTA
Middle Name:J
Last Name:BAINS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:MRS
Other - First Name:HENRIETTA
Other - Middle Name:J
Other - Last Name:BAINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:51 E 97TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7057
Mailing Address - Country:US
Mailing Address - Phone:347-259-4587
Mailing Address - Fax:
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5589
Practice Address - Country:US
Practice Address - Phone:718-579-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program