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NPI Code Detail

MEDICARE: DR. RICHARD JAY HELLER M.D.

MEDICARE: DR. RICHARD JAY HELLER M.D.
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
12084P0800XPsychiatry Physician46668MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1334604OTHERMAMAGELLAN BEHAVIORAL HEALT
2B47184OTHERMABLUE CROSS BLUE SHIELD
3011256OTHERMAHARVARD PILGRIM HEALTH CA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5706760OTHERMATUFTS HEALTH CARE

General Provider Information

NPI Number : 1356401723
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD JAY HELLER M.D.
Provider Business Mailing Address
First Line : 35 SHERMAN ST
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02138-6730
Country : US
Telephone Number : 617-576-0044
Fax Number : 978-327-5205
Provider Business Practice Location Address
First Line : 471 ANDOVER ST
Second Line :
City : NORTH ANDOVER
State : MA
Zip : 01845-5036
Country : US
Telephone Number : 978-725-8900
Fax Number : 978-327-5205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/08/2007

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