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General NPI Number Information
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NPI Number | 1306709126
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Entity Type | Organization
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Legal Business Name | HENDRICKSON CLINICAL INNOVATIONS GROUP, PC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 219 W FAIRMONT AVE
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City | NEW CASTLE
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State | PA
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Zip | 16105-1909
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Country | US
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Telephone | 833-604-7212
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Fax |
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Provider Business Mailing Address
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Address Line | 36 BRIARWOOD LN
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City | NEW WILMINGTON
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State | PA
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Zip | 16142-1938
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Country | US
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Telephone | 724-730-8382
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHAD SCOTT HENDRICKSON
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Credential | MD
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Telephone | 724-730-8382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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