Provider Demographics
NPI:1568437465
Name:DALZELL, HELEN M (PA)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:M
Last Name:DALZELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:D
Other - Last Name:MURPGY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:FALMOUTH HOSPITAL
Mailing Address - City:CATAUMET
Mailing Address - State:MA
Mailing Address - Zip Code:02534-0128
Mailing Address - Country:US
Mailing Address - Phone:508-563-5948
Mailing Address - Fax:
Practice Address - Street 1:489 BEARSES WAY
Practice Address - Street 2:UNIT A-4
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2707
Practice Address - Country:US
Practice Address - Phone:508-771-4095
Practice Address - Fax:508-771-9466
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AP1979Medicare ID - Type Unspecified
P95048Medicare UPIN