Provider Demographics
NPI:1770576159
Name:HAN, JOYCE H (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:H
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3542 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19136-2623
Mailing Address - Country:US
Mailing Address - Phone:215-333-6888
Mailing Address - Fax:215-333-3945
Practice Address - Street 1:3542 WELSH RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-2623
Practice Address - Country:US
Practice Address - Phone:215-333-6888
Practice Address - Fax:215-333-3945
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD06714L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0353642000OtherPERSONAL CHOICE
PA080164565OtherRR MEDICARE
PA2511777OtherAETNA
PA30008383OtherKEYSTONE MERCY
PA0353642000OtherKEYSTONE
PA589909OtherBLUE SHIELD
PA01011844738Medicaid
P2782959OtherOXFORD
0184473801OtherAMERICHOICE
PA2511777OtherAETNA
H20286Medicare UPIN