Provider Demographics
NPI:1285994954
Name:HANDRAKIS, JOHN P (PT, DPT, EDD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:HANDRAKIS
Suffix:
Gender:M
Credentials:PT, DPT, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 103RD ST
Mailing Address - Street 2:#2L
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:672 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5008
Practice Address - Country:US
Practice Address - Phone:914-722-2400
Practice Address - Fax:914-722-2406
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007347225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist