1992015093 NPI number — MRS. NITZYAH NANCY HELMAN BCBA

Table of content: MRS. NITZYAH NANCY HELMAN BCBA (NPI 1992015093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992015093 NPI number — MRS. NITZYAH NANCY HELMAN BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELMAN
Provider First Name:
NITZYAH
Provider Middle Name:
NANCY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BCBA
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:
1992015093
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 SCHOOL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST GRANBY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06026-9770
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-413-9536
Provider Business Mailing Address Fax Number:
860-838-4241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 SCHOOL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST GRANBY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06026-9770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-413-9536
Provider Business Practice Location Address Fax Number:
860-838-4241
Provider Enumeration Date:
10/07/2010

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: 103K00000X , with the licence number:  CERT # 1073444 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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