Provider Demographics
NPI:1720051774
Name:HENCI, TEUTA
Entity Type:Individual
Prefix:DR
First Name:TEUTA
Middle Name:
Last Name:HENCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 MANOA RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3536
Mailing Address - Country:US
Mailing Address - Phone:610-642-3409
Mailing Address - Fax:
Practice Address - Street 1:233 E LANCASTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-896-8009
Practice Address - Fax:610-649-7404
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD144247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics