Provider Demographics
NPI:1649446816
Name:HELLMAN, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HELLMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4612 MILLENNIUM DRIVE
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1418
Mailing Address - Country:US
Mailing Address - Phone:585-991-5012
Mailing Address - Fax:585-991-5013
Practice Address - Street 1:4612 MILLENNIUM DRIVE
Practice Address - Street 2:
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1418
Practice Address - Country:US
Practice Address - Phone:585-991-5012
Practice Address - Fax:585-991-5013
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083457171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103059AMOtherPREFERRED CARE