=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750158218
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HANI HANDY
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2023
-----------------------------------------------------
Last Update Date | 12/05/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 FOUNTAINVIEW DR
-----------------------------------------------------
City | MONSEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10952-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-249-5983
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 32 MELISSA DR
-----------------------------------------------------
City | TOTOWA
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07512-1708
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-249-5983
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 009347-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------