Healthcare Provider Details

I. General information

NPI: 1164406799
Provider Name (Legal Business Name): JAMES HELLERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S BROADWAY SUITE 100
TARRYTOWN NY
10591-4500
US

IV. Provider business mailing address

200 S BROADWAY SUITE 2-5
TARRYTOWN NY
10591-4500
US

V. Phone/Fax

Practice location:
  • Phone: 914-631-9300
  • Fax:
Mailing address:
  • Phone: 914-715-2794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number136873
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: