Provider Demographics
NPI:1881147668
Name:HELMKE, DEBRA (LAC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:HELMKE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 SAWTOOTH COVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFF
Mailing Address - State:NY
Mailing Address - Zip Code:11777
Mailing Address - Country:US
Mailing Address - Phone:631-601-4815
Mailing Address - Fax:
Practice Address - Street 1:156 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1801
Practice Address - Country:US
Practice Address - Phone:631-509-0765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005788171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist