Provider Demographics
NPI:1760525497
Name:ROSLOW, HELEN MONICA (MS, LAC)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:MONICA
Last Name:ROSLOW
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:ROSLOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LAC
Mailing Address - Street 1:12 IRMA AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-2810
Mailing Address - Country:US
Mailing Address - Phone:516-883-8860
Mailing Address - Fax:516-883-4130
Practice Address - Street 1:12 IRMA AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-2810
Practice Address - Country:US
Practice Address - Phone:516-883-8860
Practice Address - Fax:516-883-4130
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2646171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist