Provider Demographics
NPI:1396157301
Name:GOTHEINER-ZALCMAN, HELEN MYRA (RPH)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:MYRA
Last Name:GOTHEINER-ZALCMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1031
Mailing Address - Country:US
Mailing Address - Phone:516-374-5467
Mailing Address - Fax:516-374-1812
Practice Address - Street 1:740 NEW LOTS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-7319
Practice Address - Country:US
Practice Address - Phone:718-649-0180
Practice Address - Fax:718-649-2720
Is Sole Proprietor?:No
Enumeration Date:2014-05-24
Last Update Date:2014-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033322-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist