Provider Demographics
NPI:1164451001
Name:LOPA, HELENE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:HELENE
Middle Name:
Last Name:LOPA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:HELENE
Other - Middle Name:
Other - Last Name:KRAEUTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:187 MILLBURN AVENUE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041
Mailing Address - Country:US
Mailing Address - Phone:973-467-7976
Mailing Address - Fax:973-467-7971
Practice Address - Street 1:64 RIVER ROAD
Practice Address - Street 2:SUITE 1 STPT
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936
Practice Address - Country:US
Practice Address - Phone:973-428-1050
Practice Address - Fax:973-428-1051
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00656700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0807355USMedicare ID - Type Unspecified