Healthcare Provider Details

I. General information

NPI: 1740283613
Provider Name (Legal Business Name): HARRIET L. HELLMAN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 03/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 COUNTY ROAD 39A UNIT 14
SOUTHAMPTON NY
11968-5243
US

IV. Provider business mailing address

PO BOX 1375
WATER MILL NY
11976-1375
US

V. Phone/Fax

Practice location:
  • Phone: 631-726-8033
  • Fax: 631-726-8031
Mailing address:
  • Phone: 631-726-5859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF380116
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: