Basic Information
| Provider Information | |||||||||
| NPI: | 1780619494 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWLAND | ||||||||
| FirstName: | TODD | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7785 NORTH STATE STREET | ||||||||
| Address2: | |||||||||
| City: | LOWVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153765252 | ||||||||
| FaxNumber: | 3153769317 | ||||||||
| Practice Location | |||||||||
| Address1: | 7785 NORTH STATE STREET | ||||||||
| Address2: | |||||||||
| City: | LOWVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 13367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153765252 | ||||||||
| FaxNumber: | 3153769317 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 08/22/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 240323-1 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02836097 | 05 | NY | MEDICAID |