Basic Information
| Provider Information | |||||||||
| NPI: | 1205139870 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANOKHIN-MOGILNAY | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | C.R.N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1447 YORK RD STE 506 | ||||||||
| Address2: | |||||||||
| City: | LUTHERVILLE TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210936022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108252281 | ||||||||
| FaxNumber: | 4435485705 | ||||||||
| Practice Location | |||||||||
| Address1: | 203 BRYAN WAY | ||||||||
| Address2: | STE A | ||||||||
| City: | REISTERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211365958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108521020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2010 | ||||||||
| LastUpdateDate: | 01/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | R131846 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | R131846 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 570114700 | 01 | MD | MEDICAL ASSISTANCE | OTHER | 216903ZDVX | 01 | MD | MEDICARE | OTHER |