Provider Demographics
NPI:1306841531
Name:HOWARD, MICHAEL G (OD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:G
Last Name:HOWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3095 HARLEM RD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2500
Mailing Address - Country:US
Mailing Address - Phone:716-896-8831
Mailing Address - Fax:716-896-2318
Practice Address - Street 1:7960 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4117
Practice Address - Country:US
Practice Address - Phone:716-633-9736
Practice Address - Fax:716-896-2318
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT95569Medicare UPIN
NYG75581Medicare ID - Type Unspecified