Provider Demographics
NPI:1154497782
Name:WOLPERT, HELAINE (MD)
Entity Type:Individual
Prefix:
First Name:HELAINE
Middle Name:
Last Name:WOLPERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 MOODY STREET
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:MA
Mailing Address - Zip Code:01056-1246
Mailing Address - Country:US
Mailing Address - Phone:800-866-6663
Mailing Address - Fax:413-589-0761
Practice Address - Street 1:211 PARK STREET
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3143
Practice Address - Country:US
Practice Address - Phone:508-222-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58813207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA63002OtherFALLON COMMUNITY HEALTH P
MAY02815OtherBCBS
MA3050742OtherCHILDRENS MEDICAL SECURIT
MA3050742Medicaid
MA000000028445OtherBMC HEALTHNET
MA616313OtherTUFTS
MA0013864OtherNEIGHBORHOOD HEALTH PLAN
MA643382OtherHARVARD PILGRIM HEALTHCAR
MAY02815OtherBCBS
F76174Medicare UPIN