Healthcare Provider Details

I. General information

NPI: 1295346849
Provider Name (Legal Business Name): ALEXANDER HELLYAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2020
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 LITTLE ALUM RD
BRIMFIELD MA
01010-9632
US

IV. Provider business mailing address

145 LITTLE ALUM RD
BRIMFIELD MA
01010-9632
US

V. Phone/Fax

Practice location:
  • Phone: 413-245-3960
  • Fax:
Mailing address:
  • Phone: 508-612-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: