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General NPI Number Information
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NPI Number | 1326270836
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Entity Type | Organization
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Legal Business Name | BRUCE HELLER M D P C
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 315 W 57TH ST SUITE 405
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City | NEW YORK
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State | NY
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Zip | 10019-3158
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Country | US
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Telephone | 212-245-8123
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Fax | 212-765-0601
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Provider Business Mailing Address
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Address Line | 315 W 57TH ST SUITE 405
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City | NEW YORK
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State | NY
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Zip | 10019-3158
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Country | US
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Telephone | 212-245-8123
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Fax | 212-765-0601
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRUCE HELLER
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Credential | M.D.
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Telephone | 212-245-8123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 127969
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 233858
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 215947
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 136938
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License Number State | NY
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