Provider Demographics
NPI:1275548703
Name:PAVLOV, HELENE (MD)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:
Last Name:PAVLOV
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 1:535 E 70TH ST
Mailing Address - Street 2:HOSPITAL FOR SPECIAL SURGERY - RADIOLOGY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-606-1132
Mailing Address - Fax:212-734-7378
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:HOSPITAL FOR SPECIAL SURGERY - RADIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:212-606-1132
Practice Address - Fax:212-734-7378
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1172212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00525815Medicaid
NY00637403Medicaid
NYHP058A2010Medicare ID - Type Unspecified
NYHS0W067410Medicare ID - Type UnspecifiedGROUP NUMBER
B16854Medicare UPIN