Provider Demographics
NPI:1336168442
Name:TEPPER, HOWARD N (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:N
Last Name:TEPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOWARD
Other - Middle Name:N
Other - Last Name:TEPPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:955 S SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 105 BLDG. A
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3570
Mailing Address - Country:US
Mailing Address - Phone:908-654-6540
Mailing Address - Fax:908-654-6504
Practice Address - Street 1:955 S SPRINGFIELD AVE
Practice Address - Street 2:SUITE 105 BLDG. A
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3570
Practice Address - Country:US
Practice Address - Phone:908-654-6540
Practice Address - Fax:908-654-6504
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03890400208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0857807Medicaid
NJ0857807Medicaid
NJ100793Medicare PIN