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NPI Code Detail

MEDICARE: MRS. HELEN TRACY WOLEK RPH, MS

MEDICARE: MRS. HELEN TRACY WOLEK RPH, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist038153NY

General Provider Information

NPI Number : 1417100793
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HELEN TRACY WOLEK RPH, MS
Provider Business Mailing Address
First Line : 2834 ROUTE 17M
Second Line :
City : NEW HAMPTON
State : NY
Zip : 10958-5011
Country : US
Telephone Number : 845-374-8700
Fax Number :
Provider Business Practice Location Address
First Line : 2834 ROUTE 17M
Second Line :
City : NEW HAMPTON
State : NY
Zip : 10958-5011
Country : US
Telephone Number : 845-374-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2008
Last Update Date : 10/30/2008

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