Provider Demographics
NPI:1083606818
Name:BOSTWICK, HOWARD E (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:E
Last Name:BOSTWICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-367-0000
Mailing Address - Fax:914-367-0001
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE. 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-367-0000
Practice Address - Fax:914-367-0001
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2013-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1602252080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01014433Medicaid
NY01014433Medicaid
NY93D90EA201Medicare PIN