Provider Demographics
NPI:1457561748
Name:HELLMAN, GARY LEE (MDIV)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEE
Last Name:HELLMAN
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W 11TH ST
Mailing Address - Street 2:APT # 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-2217
Mailing Address - Country:US
Mailing Address - Phone:212-633-8280
Mailing Address - Fax:212-285-0029
Practice Address - Street 1:74 TRINITY PL
Practice Address - Street 2:SUITE 612
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2003
Practice Address - Country:US
Practice Address - Phone:212-242-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000626-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst