Provider Demographics
NPI:1902927171
Name:HOWARD, RAYMOND CHARLES (PT)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:CHARLES
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:LANOKA HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08734-1501
Mailing Address - Country:US
Mailing Address - Phone:609-242-9426
Mailing Address - Fax:
Practice Address - Street 1:710 AMHERST RD
Practice Address - Street 2:
Practice Address - City:LANOKA HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08734-1501
Practice Address - Country:US
Practice Address - Phone:609-242-9426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00653700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist