Provider Demographics
NPI:1083607287
Name:HOWARD, LYN JENNIFER (MB, BS)
Entity Type:Individual
Prefix:DR
First Name:LYN
Middle Name:JENNIFER
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MB, BS
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Mailing Address - Street 1:47 NEW SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3412
Mailing Address - Country:US
Mailing Address - Phone:518-262-5299
Mailing Address - Fax:518-262-6303
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5299
Practice Address - Fax:518-262-6303
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118736-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00370154Medicaid
NY34183GMedicare ID - Type Unspecified
NY00370154Medicaid