1770576159 NPI number — DR. JOYCE H HAN MD

Table of content: DR. JOYCE H HAN MD (NPI 1770576159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770576159 NPI number — DR. JOYCE H HAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAN
Provider First Name:
JOYCE
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770576159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3542 WELSH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19136-2623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-333-6888
Provider Business Mailing Address Fax Number:
215-333-3945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3542 WELSH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19136-2623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-333-6888
Provider Business Practice Location Address Fax Number:
215-333-3945
Provider Enumeration Date:
08/31/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD06714L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0353642000 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080164565 . This is a "RR MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2511777 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30008383 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0353642000 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 589909 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01011844738 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P2782959 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0184473801 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".




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