=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659031409
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RANDI MICHELLE HELFAND L.AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2021
-----------------------------------------------------
Last Update Date | 12/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 E EAGLE RD
-----------------------------------------------------
City | HAVERTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19083-1424
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-789-1120
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26 PRICE AVE
-----------------------------------------------------
City | NARBERTH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19072-2169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-236-5309
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AK001163
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------