Healthcare Provider Details

I. General information

NPI: 1396913489
Provider Name (Legal Business Name): HELENDALE DERMATOLOGY & MEDICAL SPA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 03/28/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HELENDALE RD STE 100
ROCHESTER NY
14609-3109
US

IV. Provider business mailing address

500 HELENDALE RD STE 100
ROCHESTER NY
14609-3109
US

V. Phone/Fax

Practice location:
  • Phone: 585-266-5420
  • Fax: 585-266-5423
Mailing address:
  • Phone: 585-266-5420
  • Fax: 585-266-5423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number199172
License Number StateNY

VIII. Authorized Official

Name: DR. ELIZABETH ANN ARTHUR
Title or Position: OWNER
Credential: M.D.
Phone: 585-266-5420