Provider Demographics
NPI:1598730038
Name:HANDY-BURNHAM, DENISE A (NP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:HANDY-BURNHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1515
Mailing Address - Country:US
Mailing Address - Phone:732-531-5445
Mailing Address - Fax:732-531-0225
Practice Address - Street 1:255 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1515
Practice Address - Country:US
Practice Address - Phone:732-531-5445
Practice Address - Fax:732-531-0225
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN0915700363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ637073Medicare ID - Type Unspecified
NJS63337Medicare UPIN