MEDICARE: DR. JACQUELYN CULLEN HOWITT 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	207V00000X	Obstetrics & Gynecology Physician	176957	NY
2	207VM0101X	Maternal & Fetal Medicine Physician	176957	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	010176957	OTHER	NY	EXCELLUS BCBS
2	101270CK	OTHER	NY	PREFERRED CARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407816804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELYN CULLEN HOWITT MD

Provider Business Mailing Address
First Line	:	500 HELENDALE RD
Second Line	:	LLE-10
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-266-1220
Fax Number	:	585-266-1227

Provider Business Practice Location Address
First Line	:	500 HELENDALE RD
Second Line	:	LLE-10
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-266-1220
Fax Number	:	585-266-1227

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	03/01/2010

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