Provider Demographics
NPI:1780765503
Name:HELENE M MAIR PHD PC
Entity type:Organization
Organization Name:HELENE M MAIR PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF PROFESSIONAL CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-783-1032
Mailing Address - Street 1:31 MERRICK AVE STE 20
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3406
Mailing Address - Country:US
Mailing Address - Phone:516-783-1032
Mailing Address - Fax:516-783-1032
Practice Address - Street 1:31 MERRICK AVE STE 20
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3406
Practice Address - Country:US
Practice Address - Phone:516-783-1032
Practice Address - Fax:516-783-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
NYNYS008098103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0069261002OtherEMPIRE
NY081106OtherGHI
NYV40031Medicare ID - Type Unspecified