Provider Demographics
NPI:1356353023
Name:HELLMANN, SANDRA A (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:A
Last Name:HELLMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 OLD RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:NY
Mailing Address - Zip Code:14589-9363
Mailing Address - Country:US
Mailing Address - Phone:315-483-3280
Mailing Address - Fax:315-589-4893
Practice Address - Street 1:4425 OLD RIDGE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:NY
Practice Address - Zip Code:14589-9363
Practice Address - Country:US
Practice Address - Phone:315-483-3280
Practice Address - Fax:315-589-4893
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199790208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01591982Medicaid
NYW70365Medicare ID - Type Unspecified
NYG10079Medicare UPIN