Provider Demographics
NPI:1427050103
Name:WAKSMAN, HOWARD K (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:K
Last Name:WAKSMAN
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 1:593 CRANBURY ROAD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4029
Mailing Address - Country:US
Mailing Address - Phone:732-613-8880
Mailing Address - Fax:732-613-0077
Practice Address - Street 1:593 CRANBURY ROAD
Practice Address - Street 2:SUITE 1A
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4029
Practice Address - Country:US
Practice Address - Phone:732-613-8880
Practice Address - Fax:732-613-0077
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07051300207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8185204Medicaid
NJG07194Medicare UPIN
036644CMEMedicare PIN