Provider Demographics
NPI:1932835204
Name:HELMS, MAXINE (MS, RDN, CDN)
Entity Type:Individual
Prefix:
First Name:MAXINE
Middle Name:
Last Name:HELMS
Suffix:
Gender:F
Credentials:MS, RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 NORTH DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14216-1921
Mailing Address - Country:US
Mailing Address - Phone:716-982-3279
Mailing Address - Fax:
Practice Address - Street 1:274 NORTH DRIVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-1421
Practice Address - Country:US
Practice Address - Phone:716-982-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY86114531133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY86114531OtherRDN