Provider Demographics
NPI:1225237548
Name:HANDLER, LISA ELLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ELLEN
Last Name:HANDLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BROADWAY STE 1515
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10004-3884
Mailing Address - Country:US
Mailing Address - Phone:212-269-6655
Mailing Address - Fax:212-269-2247
Practice Address - Street 1:42 BROADWAY
Practice Address - Street 2:SUITE 1515
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1617
Practice Address - Country:US
Practice Address - Phone:212-269-6655
Practice Address - Fax:212-269-2247
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0418801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice