Provider Demographics
NPI:1336208354
Name:TERRY, HOWARD PAUL (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:PAUL
Last Name:TERRY
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:TWO EXECUTIVE PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203
Mailing Address - Country:US
Mailing Address - Phone:518-482-7964
Mailing Address - Fax:
Practice Address - Street 1:TWO EXECUTIVE PARK DRIVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203
Practice Address - Country:US
Practice Address - Phone:518-482-7964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142628207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY78E261OtherEMPIRE BLUE CROSS
NY000405737001OtherBLUE SHIELD OF NORTHEASTE
NY10002032OtherCAPITAL DISTRICT PHYSICIA
NY31181OtherMOHAWK VALLEY HEALTH
NY00850179Medicaid
C59285Medicare UPIN
NY39551BMedicare ID - Type Unspecified