Provider Demographics
NPI: | 1215963731 |
---|---|
Name: | HELMI, SANAA (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | SANAA |
Middle Name: | |
Last Name: | HELMI |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 447 |
Mailing Address - Street 2: | |
Mailing Address - City: | DU BOIS |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15801-0447 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 814-375-6379 |
Mailing Address - Fax: | 814-372-2560 |
Practice Address - Street 1: | 635 MAPLE AVE |
Practice Address - Street 2: | 3RD FLOOR |
Practice Address - City: | DU BOIS |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15801-2383 |
Practice Address - Country: | US |
Practice Address - Phone: | 814-375-6379 |
Practice Address - Fax: | 814-372-2560 |
Is Sole Proprietor?: | Not Answered |
Enumeration Date: | 2006-06-25 |
Last Update Date: | 2007-07-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MD426049 | 2084P0804X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 1015181260001 | Medicaid | |
PA | HE1772450 | Other | HIGHMARK BLUE SHIELD PROV |
PA | I45579 | Medicare UPIN | |
PA | 095961HSU | Medicare ID - Type Unspecified | HGSA PROVIDER NUMBER |