Provider Demographics
NPI:1750507141
Name:HARINSTEIN, HOWARD WAYNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:WAYNE
Last Name:HARINSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4695 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1802
Mailing Address - Country:US
Mailing Address - Phone:203-334-6878
Mailing Address - Fax:203-373-1372
Practice Address - Street 1:4695 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-1802
Practice Address - Country:US
Practice Address - Phone:203-334-6878
Practice Address - Fax:203-373-1372
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT00081213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004006375Medicaid
CTC000310Medicare UPIN