Provider Demographics
NPI:1518067883
Name:HANDEL, TODD EVAN (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:EVAN
Last Name:HANDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4807
Mailing Address - Country:US
Mailing Address - Phone:401-305-5280
Mailing Address - Fax:401-305-5285
Practice Address - Street 1:1145 MAIN ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4807
Practice Address - Country:US
Practice Address - Phone:401-305-5280
Practice Address - Fax:401-305-5285
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD105992081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H40456Medicare UPIN
RI259023338Medicare ID - Type Unspecified