Provider Demographics
NPI:1407816804
Name:HOWITT, JACQUELYN CULLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:CULLEN
Last Name:HOWITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HELENDALE RD
Mailing Address - Street 2:LLE-10
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-3173
Mailing Address - Country:US
Mailing Address - Phone:585-266-1220
Mailing Address - Fax:585-266-1227
Practice Address - Street 1:500 HELENDALE RD
Practice Address - Street 2:LLE-10
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3173
Practice Address - Country:US
Practice Address - Phone:585-266-1220
Practice Address - Fax:585-266-1227
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176957207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010176957OtherEXCELLUS BCBS
NY101270CKOtherPREFERRED CARE
NY01152607Medicaid
NY101270CKOtherPREFERRED CARE
NYCC3105Medicare ID - Type Unspecified