MEDICARE: JOSE ELIAS HANDAL RRT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	227900000X	Registered Respiratory Therapist	YM014559	PA

General Provider Information

NPI Number	:	1780084988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE ELIAS HANDAL RRT

Provider Business Mailing Address
First Line	:	1926 E PIKE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-4432
Country	:	US
Telephone Number	:	215-783-1512
Fax Number	:

Provider Business Practice Location Address
First Line	:	1926 E PIKE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19124-4432
Country	:	US
Telephone Number	:	215-783-1512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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