MEDICARE: JAY HELLER D.C.

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	111NX0800X	Orthopedic Chiropractor	X006070-1	NY

General Provider Information

NPI Number	:	1992729917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY HELLER D.C.

Provider Business Mailing Address
First Line	:	119 WASHINGTON PL APT A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3875
Country	:	US
Telephone Number	:	212-741-7792
Fax Number	:	212-741-6678

Provider Business Practice Location Address
First Line	:	119 WASHINGTON PL APT A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10014-3875
Country	:	US
Telephone Number	:	212-741-7792
Fax Number	:	212-741-6678

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/05/2008

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