Provider Demographics
NPI:1073576641
Name:FOX, HOWARD R (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:R
Last Name:FOX
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:2760 AMBOY RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2141
Mailing Address - Country:US
Mailing Address - Phone:718-987-5366
Mailing Address - Fax:718-989-4879
Practice Address - Street 1:2760 AMBOY RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2141
Practice Address - Country:US
Practice Address - Phone:718-987-5366
Practice Address - Fax:718-989-4879
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN002941213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP32601Medicare PIN
NYT50938Medicare UPIN