Healthcare Provider Details

I. General information

NPI: 1841810827
Provider Name (Legal Business Name): HELENA PRIETO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 SAINT JOSEPHS BLVD STE 304
ELMIRA NY
14901-3234
US

IV. Provider business mailing address

600 IVY ST STE 206
ELMIRA NY
14905-1627
US

V. Phone/Fax

Practice location:
  • Phone: 607-737-7012
  • Fax: 607-733-5594
Mailing address:
  • Phone: 607-271-2050
  • Fax: 607-271-2071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number314869
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: