Provider Demographics
NPI:1679663504
Name:KLOTH, HOWARD H (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:H
Last Name:KLOTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-889-5800
Mailing Address - Fax:212-679-9207
Practice Address - Street 1:650 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-889-5800
Practice Address - Fax:212-679-9207
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081996207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00119493Medicaid
NY060012135OtherRAILROAD MEDICARE
NY00119493Medicaid
NY060012135OtherRAILROAD MEDICARE