Provider Demographics
NPI:1336293125
Name:RAFF, HOWARD P (LICENSE NO 000343)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:P
Last Name:RAFF
Suffix:
Gender:M
Credentials:LICENSE NO 000343
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 CHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3040
Mailing Address - Country:US
Mailing Address - Phone:860-754-2200
Mailing Address - Fax:860-754-9600
Practice Address - Street 1:678 CHASE PKWY
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3040
Practice Address - Country:US
Practice Address - Phone:860-754-2200
Practice Address - Fax:860-754-9600
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000343237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist