=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649273251
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAY J HANDLER MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2005
-----------------------------------------------------
Last Update Date | 11/05/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2137 WELSH RD STE 2D
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19115-4963
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-698-7333
-----------------------------------------------------
Fax | 215-673-9492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 8500-6335
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19178-6335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-698-7333
-----------------------------------------------------
Fax | 215-673-9492
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | MD011070E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------