Healthcare Provider Details

I. General information

NPI: 1205822566
Provider Name (Legal Business Name): COROLINDA SEHELASA HELU DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 RED MILLS RD
WALLKILL NY
12589-3220
US

IV. Provider business mailing address

800 RED MILLS RD
WALLKILL NY
12589-3220
US

V. Phone/Fax

Practice location:
  • Phone: 845-744-9105
  • Fax: 845-744-9107
Mailing address:
  • Phone: 845-744-9105
  • Fax: 845-744-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number006003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: