Provider Demographics
NPI:1043498009
Name:HOWARD W HARINSTEIN
Entity Type:Organization
Organization Name:HOWARD W HARINSTEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-334-6878
Mailing Address - Street 1:4695 MAIN ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1802
Mailing Address - Country:US
Mailing Address - Phone:203-334-6878
Mailing Address - Fax:203-373-1372
Practice Address - Street 1:4695 MAIN ST
Practice Address - Street 2:SUITE 15
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-1802
Practice Address - Country:US
Practice Address - Phone:203-334-6878
Practice Address - Fax:203-373-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000081213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0000406435Medicaid
CT0691000001Medicare NSC
CT0691000001Medicare PIN
CTC00310Medicare PIN
CT0000406435Medicaid