Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 15247 | MA |
NPI | 1578615688 |
---|---|
Provider Name | Edwin Jesse Helitzer |
First Address | Pittsfield, MA 01201-6831 |
Second Address | Pittsfield, MA 01201-6831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |