Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35SI00394400 | NJ |
Y | 103T00000X | Psychologist | 35SI00394400 | NJ |
NPI | 1003973678 |
---|---|
Provider Name | Dr. Ron Handelman |
First Address | Montclair, NJ 07043-1504 |
Second Address | Montclair, NJ 07042-3582 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |