Provider Demographics
NPI:1093266207
Name:HOWELL, FAYE
Entity Type:Individual
Prefix:
First Name:FAYE
Middle Name:
Last Name:HOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 HARLEM RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2042
Mailing Address - Country:US
Mailing Address - Phone:716-446-9500
Mailing Address - Fax:716-446-9501
Practice Address - Street 1:3620 HARLEM RD
Practice Address - Street 2:STE 2
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14215-2042
Practice Address - Country:US
Practice Address - Phone:716-446-9500
Practice Address - Fax:716-446-9501
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040548-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy