Healthcare Provider Details

I. General information

NPI: 1932275401
Provider Name (Legal Business Name): HOWARD H. COVITZ PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 LATHAM PARK
ELKINS PARK PA
19027-3148
US

IV. Provider business mailing address

24 LATHAM PARK
ELKINS PARK PA
19027-3148
US

V. Phone/Fax

Practice location:
  • Phone: 215-635-5368
  • Fax:
Mailing address:
  • Phone: 215-635-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS008549L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS008549L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TP0814X
TaxonomyPsychoanalysis Psychologist
License NumberPS008549L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: