Provider Demographics
NPI:1275936247
Name:HOWARD, STEPHEN W (PA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:104 UNION AVENUE
Mailing Address - Street 2:SUITE 804
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1844
Mailing Address - Country:US
Mailing Address - Phone:315-703-5049
Mailing Address - Fax:315-703-5079
Practice Address - Street 1:301 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203
Practice Address - Country:US
Practice Address - Phone:315-448-5111
Practice Address - Fax:315-703-5079
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2014-11-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY018101363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical