Provider Demographics
NPI:1396006409
Name:COWARD, C J (MS ED/SPED)
Entity Type:Individual
Prefix:
First Name:C
Middle Name:J
Last Name:COWARD
Suffix:
Gender:F
Credentials:MS ED/SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4075
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4075
Practice Address - Country:US
Practice Address - Phone:347-701-9448
Practice Address - Fax:347-701-9448
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY876922174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist