Provider Demographics
NPI:1215915020
Name:NATHANSON, HOWARD G (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:G
Last Name:NATHANSON
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 1:2428 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5704
Mailing Address - Country:US
Mailing Address - Phone:516-379-2689
Mailing Address - Fax:516-992-8380
Practice Address - Street 1:2428 MERRICK RD
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5704
Practice Address - Country:US
Practice Address - Phone:516-379-2689
Practice Address - Fax:516-992-8380
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116591207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY71F28XYPW1Medicare PIN
71F281Medicare ID - Type Unspecified
C08183Medicare UPIN