Healthcare Provider Details

I. General information

NPI: 1083939284
Provider Name (Legal Business Name): ADAM SHATTUCK HOWE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 HACKETT BLVD # MC-108
ALBANY NY
12208
US

IV. Provider business mailing address

1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-3341
  • Fax: 518-262-6660
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number278159
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number278159
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: