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NPI Code Detail

MEDICARE: GALLAUDET HOWARD CNP

MEDICARE: GALLAUDET HOWARD CNP
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
1207P00000XEmergency Medicine Physician107095IA
2363LF0000XFamily Nurse PractitionerRN206843MA

Other Identifiers

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

General Provider Information

NPI Number : 1730149113
Entity Type Code : Individual
Provider Name (Legal Business Name) : GALLAUDET HOWARD CNP
Provider Business Mailing Address
First Line : P.O. BOX 526
Second Line :
City : LYNN
State : MA
Zip : 01903
Country : US
Telephone Number : 781-596-2502
Fax Number : 781-596-3966
Provider Business Practice Location Address
First Line : 269 UNION ST
Second Line :
City : LYNN
State : MA
Zip : 01901-1314
Country : US
Telephone Number : 781-581-3900
Fax Number : 781-598-1050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 05/25/2017

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