Provider Demographics
NPI:1548337264
Name:MEDICAN, HELGA M (OTR L)
Entity type:Individual
Prefix:
First Name:HELGA
Middle Name:M
Last Name:MEDICAN
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:46 SUGARLOAF MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-2425
Mailing Address - Country:US
Mailing Address - Phone:845-469-2728
Mailing Address - Fax:
Practice Address - Street 1:162 E BROADWAY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-8815
Practice Address - Country:US
Practice Address - Phone:845-796-1350
Practice Address - Fax:845-796-1647
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003895-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY87761OtherGHI
NYQ90121OtherEMPIREBLUECROSSBLUESHIELD