Provider Demographics
NPI:1952382467
Name:HENCZEL, HENRY K (DPM)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:K
Last Name:HENCZEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-856-9181
Mailing Address - Fax:508-425-6177
Practice Address - Street 1:5 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-856-9181
Practice Address - Fax:508-425-6177
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2178213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942551OtherFIRST HEALTH
480033534OtherRAILROAD MEDICARE
3041376OtherCIGNA HEALTH PLAN
64771OtherFALLON COMMUNITY HLTH PL
Y71093OtherBLUE CARE ELECT
0362221OtherMEDICAID/WELFARE
042472266OtherTHREE RIVERS
042472266OtherONE HEALTH PLAN
2700630OtherEVERCARE
7823120OtherAETNA/US HEALTHCARE
Y71093OtherBLUE SHIELD HMO BLUE
042472266OtherHEALTHCARE VALUE MNGMENT
042472266OtherPRIVATE HEALTHCARE SYSTEM
Y71093OtherBLUE SHIELD INDEMNITY
Y75109OtherMEDICARE B
785955OtherMVP HEALTH CARE
AA5964OtherHARVARD PILGRIM HEALTHCAR
480033534OtherRAILROAD MEDICARE
Y71093OtherBLUE SHIELD HMO BLUE