Healthcare Provider Details

I. General information

NPI: 1366410565
Provider Name (Legal Business Name): CARLA JEANNE HOWARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 PROSPECT PLACE CROWN HEIGHTS CHILD HEALTH CLINIC
BROOKLYN NY
11213-2211
US

IV. Provider business mailing address

1043 E 39 ST
BROOKLYN NY
11210
US

V. Phone/Fax

Practice location:
  • Phone: 718-735-0561
  • Fax: 718-735-6079
Mailing address:
  • Phone: 718-377-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number220063
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: