Provider Demographics
NPI:1013239656
Name:DEAN, HELENANN MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:HELENANN
Middle Name:MARIE
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SHELL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11778-9740
Mailing Address - Country:US
Mailing Address - Phone:631-744-3416
Mailing Address - Fax:631-209-9779
Practice Address - Street 1:8 SHELL RD
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11778-9740
Practice Address - Country:US
Practice Address - Phone:631-744-3416
Practice Address - Fax:631-209-9779
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012250225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist