1215104229 NPI number — MS. CORDELIA SCHMIDT HELLERAU PHD

Table of content: MS. CORDELIA SCHMIDT HELLERAU PHD (NPI 1215104229)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215104229 NPI number — MS. CORDELIA SCHMIDT HELLERAU PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT HELLERAU
Provider First Name:
CORDELIA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215104229
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
246 ELIOT STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-232-5726
Provider Business Mailing Address Fax Number:
617-734-3095

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
246 ELIOT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTNUT HILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-232-5726
Provider Business Practice Location Address Fax Number:
617-734-3095
Provider Enumeration Date:
05/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 102L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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