Provider Demographics
NPI:1043329196
Name:HOWARD, CHRISTIAN J (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:J
Last Name:HOWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 N FRALEY ST
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-1164
Mailing Address - Country:US
Mailing Address - Phone:814-837-7880
Mailing Address - Fax:814-837-0883
Practice Address - Street 1:175 N FRALEY ST
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-1164
Practice Address - Country:US
Practice Address - Phone:814-837-7880
Practice Address - Fax:814-837-0883
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000844152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0496620001Medicare NSC
PA049565Medicare PIN
PAT27602Medicare UPIN