MEDICARE: DR. HOWARD JOSEPH ALLEN LCSW

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	1041C0700X	Clinical Social Worker	069390	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000587694007	OTHER	NY	HEALTH NOW
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780669358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD JOSEPH ALLEN LCSW

Provider Business Mailing Address
First Line	:	11417 EDEN RD
Second Line	:	P.O. BOX 623
City	:	NORTH COLLINS
State	:	NY
Zip	:	14111-9738
Country	:	US
Telephone Number	:	716-337-3092
Fax Number	:	716-337-3092

Provider Business Practice Location Address
First Line	:	11417 EDEN RD
Second Line	:
City	:	NORTH COLLINS
State	:	NY
Zip	:	14111-9738
Country	:	US
Telephone Number	:	716-337-3092
Fax Number	:	716-337-3092

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	07/09/2007

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