1831163989 NPI number — DAVID P HELPA CCCSLP

Table of content: DAVID P HELPA CCCSLP (NPI 1831163989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831163989 NPI number — DAVID P HELPA CCCSLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELPA
Provider First Name:
DAVID
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CCCSLP
Provider Gender Code:
M

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:
1831163989
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 HERITAGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01540-1763
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-987-2812
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 EVERGREEN DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02914-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-438-3250
Provider Business Practice Location Address Fax Number:
401-438-4813
Provider Enumeration Date:
02/15/2006

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: 235Z00000X , with the licence number:  651 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0374784 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: SP0080 . This is a "BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: SP0080 . This is a "BLUE SHIELD INDEMNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 35481155 . This is a "CIGNA HEALTHSOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA4054 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0374784 . This is a "MEDICAID WELFARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2779432 . This is a "CIGNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 43203 . This is a "FALLON COMMUNITY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2779432001 . This is a "CIGNA PAL ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7293594 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: SP0080 . This is a "BLUE SHIELD HMO BLUE" identifier . This identifiers is of the category "OTHER".




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