MEDICARE: HELEN M DALZELL PA

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
1	363A00000X	Physician Assistant	1165	MA

General Provider Information

NPI Number	:	1568437465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN M DALZELL PA

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:	FALMOUTH HOSPITAL
City	:	CATAUMET
State	:	MA
Zip	:	02534-0128
Country	:	US
Telephone Number	:	508-563-5948
Fax Number	:

Provider Business Practice Location Address
First Line	:	489 BEARSES WAY
Second Line	:	UNIT A-4
City	:	HYANNIS
State	:	MA
Zip	:	02601-2707
Country	:	US
Telephone Number	:	508-771-4095
Fax Number	:	508-771-9466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	03/08/2012

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