Provider Demographics
NPI:1043803190
Name:ZELNICK, HELENA
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:
Last Name:ZELNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14002 E 83RD ST N APT 101
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-7610
Mailing Address - Country:US
Mailing Address - Phone:918-260-3298
Mailing Address - Fax:
Practice Address - Street 1:3751 N ASPEN AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1109
Practice Address - Country:US
Practice Address - Phone:918-260-3298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19050183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist