Provider Demographics
NPI:1730180167
Name:FUTERMAN, HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:FUTERMAN
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 1:833 NORTHERN BLVD.
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5315
Mailing Address - Country:US
Mailing Address - Phone:516-829-1919
Mailing Address - Fax:516-829-9641
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5315
Practice Address - Country:US
Practice Address - Phone:516-829-1919
Practice Address - Fax:516-829-9641
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166550207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01654113Medicaid
A62266Medicare UPIN
NY33E851Medicare ID - Type UnspecifiedEMPIRE BLUE CROSS/SHIELD
NY01654113Medicaid