Provider Demographics
NPI:1205822566
Name:HELU, COROLINDA SEHELASA (DPM)
Entity Type:Individual
Prefix:
First Name:COROLINDA
Middle Name:SEHELASA
Last Name:HELU
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 RED MILLS RD
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-6218
Mailing Address - Country:US
Mailing Address - Phone:845-913-7026
Mailing Address - Fax:775-996-2815
Practice Address - Street 1:262 RED MILLS RD
Practice Address - Street 2:
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566-6218
Practice Address - Country:US
Practice Address - Phone:845-913-7026
Practice Address - Fax:775-996-2815
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0107213ES0103X
NYN006003213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6501420001Medicare NSC
NYA300045505Medicare PIN
NVV39676Medicare PIN
NVV39678Medicare PIN
NVU87576Medicare UPIN
NVDC4309Medicare PIN