Provider Demographics
NPI:1073825337
Name:HENRY, MARIA KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:KATHERINE
Last Name:HENRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 CIVIC CENTER BLVD, DIVISION OF GENERAL PEDIATRICS
Mailing Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-1000
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD, DIVISION OF GENERAL PEDIATRICS
Practice Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197084208000000X, 2080C0008X
PAMD448022208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics