Provider Demographics
NPI:1205092467
Name:HENRY, HAKEEMA R (MD)
Entity type:Individual
Prefix:
First Name:HAKEEMA
Middle Name:R
Last Name:HENRY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:7 WELLS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1200
Practice Address - Country:US
Practice Address - Phone:518-587-1553
Practice Address - Fax:518-587-1691
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2010-08-27
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Provider Licenses
StateLicense IDTaxonomies
NY248371207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03023127Medicaid
NYRB9318Medicare PIN