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Back Bay MD LLC — NPI 1972460244, Malden, MA | NPI Central

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NPI 1972460244

OrganizationActive

Back Bay MD LLC

NPI 1972460244 · Clinic/Center · Malden, MA

Provider details

NPI number: 1972460244
Entity type: Organization
Primary specialty: Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Luis Henkel, Owner and Medical Director(857) 200-8997

Specialties & taxonomies

Clinic/CenterPrimary261Q00000X
Ambulatory Health Care Facilities

Practice location

578 Main St Unit B5

Malden, MA 02148-4094

Phone: (857) 200-8997

Approximate (ZIP-level) locationGet directions

More MA providers

Mailing address

578 Main St Unit B5

Malden, MA 02148-4094

Registry dates

Enumerated: 2026-01-07
Last updated: 2026-01-07
Certified: 2026-01-07

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.