1700968112 NPI number — HOPE N HELLER PHD

Table of content: HOPE N HELLER PHD (NPI 1700968112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700968112 NPI number — HOPE N HELLER PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELLER
Provider First Name:
HOPE
Provider Middle Name:
N
Provider Name Prefix Text:
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:
1700968112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10411 CLAYTON RD
Provider Second Line Business Mailing Address:
STE 305
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63131-2913
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-567-7500
Provider Business Mailing Address Fax Number:
314-567-8512

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10411 CLAYTON RD
Provider Second Line Business Practice Location Address:
STE 305
Provider Business Practice Location Address City Name:
SAINT LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63131-2913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-567-7500
Provider Business Practice Location Address Fax Number:
314-567-8512
Provider Enumeration Date:
10/19/2006

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: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000144 . This is a "MISSOURI STATE LICENSE NO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com