MEDICARE: MS. CARLA JEANNE HOWARD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	220063	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366410565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARLA JEANNE HOWARD MD

Provider Business Mailing Address
First Line	:	1043 E 39 ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210
Country	:	US
Telephone Number	:	718-377-3432
Fax Number	:

Provider Business Practice Location Address
First Line	:	1218 PROSPECT PLACE
Second Line	:	CROWN HEIGHTS CHILD HEALTH CLINIC
City	:	BROOKLYN
State	:	NY
Zip	:	11213-2211
Country	:	US
Telephone Number	:	718-735-0561
Fax Number	:	718-735-6079

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/30/2015

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