1639229651 NPI number — MRS. PAYCE JO-HANNA HANDLER HALEY

Table of content: MRS. PAYCE JO-HANNA HANDLER HALEY (NPI 1639229651)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639229651 NPI number — MRS. PAYCE JO-HANNA HANDLER HALEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANDLER HALEY
Provider First Name:
PAYCE
Provider Middle Name:
JO-HANNA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HANDLER
Provider Other First Name:
PAYCE
Provider Other Middle Name:
JO- HANNA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1639229651
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6705 CINNAMON DR
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:
19128-4550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-870-5616
Provider Business Mailing Address Fax Number:
215-508-1197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2705 DEKALB PIKE
Provider Second Line Business Practice Location Address:
SUITE 309
Provider Business Practice Location Address City Name:
NORRISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19401-1852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-275-0200
Provider Business Practice Location Address Fax Number:
610-275-4436
Provider Enumeration Date:
01/11/2007

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: 207R00000X , with the licence number:  OS013060 , 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)





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