Healthcare Provider Details

I. General information

NPI: 1861487035
Provider Name (Legal Business Name): JOY L HELLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4667 W CHESTER PIKE
NEWTOWN SQUARE PA
19073-2227
US

IV. Provider business mailing address

412 CREAMERY WAY STE 400
EXTON PA
19341-2551
US

V. Phone/Fax

Practice location:
  • Phone: 610-356-7870
  • Fax: 610-594-2625
Mailing address:
  • Phone: 610-594-7590
  • Fax: 610-594-7597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS007500L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: