Healthcare Provider Details

I. General information

NPI: 1154497782
Provider Name (Legal Business Name): HELAINE WOLPERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 PARK STREET
ATTLEBORO MA
02703-3143
US

IV. Provider business mailing address

291 MOODY STREET
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 508-222-5200
  • Fax:
Mailing address:
  • Phone: 800-866-6663
  • Fax: 413-589-0761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number58813
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: