Provider Demographics
NPI:1467611202
Name:GOLDMAN, HOWARD ALLEN (RPH)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:ALLEN
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W 207TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-2609
Mailing Address - Country:US
Mailing Address - Phone:212-304-0101
Mailing Address - Fax:212-304-0788
Practice Address - Street 1:506 W 207TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-2609
Practice Address - Country:US
Practice Address - Phone:212-304-0101
Practice Address - Fax:212-304-0788
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023491-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist