Provider Demographics
NPI:1558444802
Name:HANDELSMAN, RICHARD E (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:HANDELSMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 FIREMANS MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:800-750-8616
Mailing Address - Fax:845-362-8474
Practice Address - Street 1:7C MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3516
Practice Address - Country:US
Practice Address - Phone:845-362-1169
Practice Address - Fax:845-362-0111
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00510554Medicaid
NY00510554Medicaid
NY37A081Medicare ID - Type Unspecified