MEDICARE: HOWARD K WAKSMAN 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	207RP1001X	Pulmonary Disease Physician	25MA07051300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427050103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD K WAKSMAN MD

Provider Business Mailing Address
First Line	:	593 CRANBURY ROAD
Second Line	:	SUITE 1A
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-4029
Country	:	US
Telephone Number	:	732-613-8880
Fax Number	:	732-613-0077

Provider Business Practice Location Address
First Line	:	593 CRANBURY ROAD
Second Line	:	SUITE 1A
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-4029
Country	:	US
Telephone Number	:	732-613-8880
Fax Number	:	732-613-0077

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	02/19/2016

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