Provider Demographics
NPI:1356593248
Name:AURICCHIO, HELEN G (RPH)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:G
Last Name:AURICCHIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2849
Mailing Address - Country:US
Mailing Address - Phone:631-751-5612
Mailing Address - Fax:631-751-5146
Practice Address - Street 1:158 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2849
Practice Address - Country:US
Practice Address - Phone:631-751-5612
Practice Address - Fax:631-751-5146
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31475183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01325566Medicaid