MEDICARE: DR. H. BRAD HENKEN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	OS007510L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215929179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. H. BRAD HENKEN DO

Provider Business Mailing Address
First Line	:	1824 GOOD HOPE ROAD
Second Line	:	SUITE 201
City	:	ENOLA
State	:	PA
Zip	:	17025-1233
Country	:	US
Telephone Number	:	717-791-2680
Fax Number	:	717-791-2686

Provider Business Practice Location Address
First Line	:	1824 GOOD HOPE ROAD
Second Line	:	SUITE 201
City	:	ENOLA
State	:	PA
Zip	:	17025-1233
Country	:	US
Telephone Number	:	717-791-2680
Fax Number	:	717-791-2686

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	03/17/2025

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