Basic Information
| Provider Information | |||||||||
| NPI: | 1083051759 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | ANDRE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1939 W CHELTENHAM AVE | ||||||||
| Address2: | |||||||||
| City: | ELKINS PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190271046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158845715 | ||||||||
| FaxNumber: | 2158841442 | ||||||||
| Practice Location | |||||||||
| Address1: | 1939 W CHELTENHAM AVE | ||||||||
| Address2: | |||||||||
| City: | ELKINS PARK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190271046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158845715 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2013 | ||||||||
| LastUpdateDate: | 06/22/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD466546 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.