Provider Demographics
NPI:1356401723
Name:HELLER, RICHARD JAY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAY
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:35 SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-6730
Mailing Address - Country:US
Mailing Address - Phone:617-576-0044
Mailing Address - Fax:978-327-5205
Practice Address - Street 1:471 ANDOVER ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5036
Practice Address - Country:US
Practice Address - Phone:978-725-8900
Practice Address - Fax:978-327-5205
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA466682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA334604OtherMAGELLAN BEHAVIORAL HEALT
MAB47184OtherBLUE CROSS BLUE SHIELD
MA011256OtherHARVARD PILGRIM HEALTH CA
MA0156469Medicaid
MA706760OtherTUFTS HEALTH CARE
MA011256OtherHARVARD PILGRIM HEALTH CA
MA334604OtherMAGELLAN BEHAVIORAL HEALT