Healthcare Provider Details

I. General information

NPI: 1932233137
Provider Name (Legal Business Name): CHARLENE KROLL HELLER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 BABBITT RD SUITE 8
BEDFORD HILLS NY
10507-1836
US

IV. Provider business mailing address

51 BABBITT RD SUITE 8
BEDFORD HILLS NY
10507-1836
US

V. Phone/Fax

Practice location:
  • Phone: 914-263-1988
  • Fax:
Mailing address:
  • Phone: 914-263-1988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number000970-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: