Provider Demographics
NPI:1720896087
Name:HANDEL, JOHN E
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:HANDEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-9780
Mailing Address - Country:US
Mailing Address - Phone:410-861-3769
Mailing Address - Fax:
Practice Address - Street 1:5 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NY
Practice Address - Zip Code:14414-9780
Practice Address - Country:US
Practice Address - Phone:410-861-3769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099151101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health