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General NPI Number Information
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NPI Number | 1154788495
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Entity Type | Individual
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Provider Name | HELENE RIESENBERG
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Gender | Female
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 8812 CROMWELL DR
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City | SPRINGFIELD
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State | VA
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Zip | 22151-1118
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Country | US
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Telephone | 773-744-3898
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Fax |
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Provider Business Mailing Address
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Address Line | 8812 CROMWELL DR
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City | SPRINGFIELD
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State | VA
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Zip | 22151-1118
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Country | US
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Telephone | 773-744-3898
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202211994
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051286617
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19031
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License Number State | IA
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