Provider Demographics
NPI:1194941658
Name:HANDRON, JOHN DOWER (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DOWER
Last Name:HANDRON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21430 SPRUCE RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:KS
Mailing Address - Zip Code:66020-8048
Mailing Address - Country:US
Mailing Address - Phone:609-420-7102
Mailing Address - Fax:
Practice Address - Street 1:901 ROUTE 168 STE 101
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3200
Practice Address - Country:US
Practice Address - Phone:609-408-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00179900103TP0814X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R33030Medicare UPIN
638565Medicare ID - Type Unspecified