Basic Information
Provider Information
NPI: 1760555023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HELLERSTEIN
FirstName: ANN
MiddleName: ISABEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: PPQA MEDICARE COMPLIANCE UNIT 6 WEST ATTN THERESA BROOK
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 501 NORTH FREDERICK AVENUE
Address2:  
City: GAITHERSBURG
State: MD
PostalCode: 208772598
CountryCode: US
TelephoneNumber: 3012587265
FaxNumber: 3012587294
Other Information
ProviderEnumerationDate: 11/16/2006
LastUpdateDate: 09/19/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XD36696MDY Allopathic & Osteopathic PhysiciansPediatrics 
208000000XMD16176DCN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X0101223332VAN Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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