Provider Demographics
NPI:1790035806
Name:EMERICK, MARY HELENE (LPN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELENE
Last Name:EMERICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 BROOKEDGE DR
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:NY
Mailing Address - Zip Code:14464-9350
Mailing Address - Country:US
Mailing Address - Phone:585-747-1049
Mailing Address - Fax:
Practice Address - Street 1:1415 BROOKEDGE DR
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:NY
Practice Address - Zip Code:14464-9350
Practice Address - Country:US
Practice Address - Phone:585-747-1049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-16
Last Update Date:2012-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234410-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse