Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DS025404L | PA |
Y | 1223D0004X | Dentist Anesthesiologist | DS025404L | PA |
NPI | 1275552234 |
---|---|
Provider Name | Stanley James Heleniak |
First Address | Lansdale, PA 19446 |
Second Address | Lansdale, PA 19446-4883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 02/09/2013 |