Provider Demographics
NPI:1962380113
Name:SIQUEIRA MENDONCA, MARIA HELENA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MARIA HELENA
Middle Name:
Last Name:SIQUEIRA MENDONCA
Suffix:
Gender:X
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RUA AMERICO ALVES PEREIRA FILHO 523
Mailing Address - Street 2:APT 251
Mailing Address - City:SAO PAULO
Mailing Address - State:NOT APPLICABLE
Mailing Address - Zip Code:05688000
Mailing Address - Country:BR
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE N
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01655-0002
Practice Address - Country:US
Practice Address - Phone:855-862-7763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ487002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology