Provider Demographics
NPI:1659781417
Name:HELM, THOMAS DANIEL
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:DANIEL
Last Name:HELM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 76TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1202
Mailing Address - Country:US
Mailing Address - Phone:516-643-2933
Mailing Address - Fax:718-785-9769
Practice Address - Street 1:21-17 76TH STREET
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370
Practice Address - Country:US
Practice Address - Phone:516-643-2933
Practice Address - Fax:718-785-9769
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002811133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered