Provider Demographics
NPI:1417435173
Name:HEILIG, ELISEBETH J (MS ED)
Entity Type:Individual
Prefix:
First Name:ELISEBETH
Middle Name:J
Last Name:HEILIG
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4562
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-8562
Mailing Address - Country:US
Mailing Address - Phone:845-978-9569
Mailing Address - Fax:
Practice Address - Street 1:88 RED MILLS RD
Practice Address - Street 2:
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566-6213
Practice Address - Country:US
Practice Address - Phone:845-978-9569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other