Individual provider Active NPI

Helene Marie Bolina

  • Psychiatry Physician
  • West Brentwood, NY
National Provider Identifier
1689165458
Registry record updated May 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
456838 Issued in NY
Practice address
998 Crooked Hill Rd
West Brentwood, NY 11717-1019
Phone
(631) 761-2680
Fax
(631) 761-2069
NPI assigned
May 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 456838 NY Primary

Addresses

Primary practice location

998 Crooked Hill Rd
West Brentwood, NY 11717-1019

Mailing address

230 Springmeadow Dr Unit F
Holbrook, NY 11741-4135
Phone (631) 761-2680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
456838NYMDPsychiatry Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527465600000",
    "number": "1689165458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SPRINGMEADOW DR UNIT F",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414135",
            "telephone_number": "631-761-2680",
            "fax_number": "631-761-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 CROOKED HILL RD",
            "city": "WEST BRENTWOOD",
            "state": "NY",
            "postal_code": "117171019",
            "telephone_number": "631-761-2680",
            "fax_number": "631-761-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLINA",
        "first_name": "HELENE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-28",
        "last_updated": "2018-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "456838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.