National Provider Identifier
Douglas R Henneberg, ATC
Douglas R Henneberg, ATC is listed in the NPPES registry with a primary specialty of Sports Medicine (Physical Medicine & Rehabilitation) Physician in Rochester, NY and a listed phone number of (585) 292-2848.
Profile Overview
- NPI
- 1164096962
- Provider Type
- Individual
- Primary Specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Enumeration Date
- May 17, 2021
- Last Updated
- May 17, 2021
Practice Location
- 1000 E Henrietta RD
- Rochester, NY 14623-5701
Phone: (585) 292-2848
Specialties
- Sports Medicine (Physical Medicine & Rehabilitation) Physician (2081S0010X)
Endpoints
- WEBSTER
Other Url | Webster, NY 14580
Full Record
- NPI
- 1164096962
- Entity Type
- Individual
- Last Name
- Henneberg
- First Name
- Douglas
- Middle Name
- R
- Credential
- ATC
- Mailing Street Address
- 1000 E Henrietta RD
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14623-5701
- Mailing Country
- US
- Mailing Phone
- (585) 292-2848
- Practice Street Address
- 1000 E Henrietta RD
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14623-5701
- Practice Country
- US
- Practice Phone
- (585) 292-2848
- Enumeration Date
- May 17, 2021
- Last Updated
- May 17, 2021
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- May 17, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) Physician (2081S0010X)