Healthcare Provider Details

I. General information

NPI: 1265067888
Provider Name (Legal Business Name): MCCALL HELSTROM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 PARK AVE S FL 9
NEW YORK NY
10016-7570
US

IV. Provider business mailing address

461 PARK AVE S FL 9
NEW YORK NY
10016-7570
US

V. Phone/Fax

Practice location:
  • Phone: 212-545-1888
  • Fax:
Mailing address:
  • Phone: 212-545-1888
  • Fax: 212-545-1919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number031222
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-2173
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: