Basic Information
Provider Information | |||||||||
NPI: | 1285675009 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | VOLOKHONSKY | ||||||||
FirstName: | HELEN | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 41 UNIVERSITY DR STE 300 | ||||||||
Address2: |   | ||||||||
City: | NEWTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 189401873 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2157107037 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1609 WOODBOURNE RD STE 101 | ||||||||
Address2: |   | ||||||||
City: | LEVITTOWN | ||||||||
State: | PA | ||||||||
PostalCode: | 190571520 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2159451500 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/10/2006 | ||||||||
LastUpdateDate: | 05/20/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 05/20/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD071119L | PA | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 10667424 | 01 | PA | CAQH ID# | OTHER | 2069890000 | 01 | PA | AMERIHEALTH/INTERCOUNTY | OTHER | 16523-MD071119L | 01 | PA | HEALTH PARTNERS | OTHER | 2069890000 | 01 | PA | IBC - PC/KHPE | OTHER | P00183506/DC5012 | 01 | PA | RRM | OTHER | 236954 | 01 | PA | ALLIANCE/OPT CHC (MAMSI) | OTHER | 3061525 | 01 | PA | AETNA HMO | OTHER | 7492390 | 01 | PA | AETNA PPO | OTHER | 4407365 | 01 | PA | CIGNA HMO/PPO | OTHER | 1378594 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 0019130760003 | 05 | PA |   | MEDICAID | 30028658 | 01 | PA | KEYSTONE MERCY | OTHER |