Provider Demographics
NPI:1780713693
Name:MUHAMMAD A HENA PC
Entity type:Organization
Organization Name:MUHAMMAD A HENA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-489-4791
Mailing Address - Street 1:4 ATRIUM DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1441
Mailing Address - Country:US
Mailing Address - Phone:518-489-4791
Mailing Address - Fax:518-489-4793
Practice Address - Street 1:4 ATRIUM DR
Practice Address - Street 2:SUITE 230
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1441
Practice Address - Country:US
Practice Address - Phone:518-489-4791
Practice Address - Fax:518-489-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113461-12086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00542030Medicaid
NYD73967Medicare UPIN
NYDD6048Medicare ID - Type UnspecifiedMEDICARE