Healthcare Provider Details

I. General information

NPI: 1114840501
Provider Name (Legal Business Name): CHELSEA HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 COUNTY ROAD 101
YAPHANK NY
11980-9640
US

IV. Provider business mailing address

46 HILLSIDE RD
FARMINGVILLE NY
11738-1602
US

V. Phone/Fax

Practice location:
  • Phone: 631-924-5583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number1796343241
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: