Provider Demographics
NPI:1174597215
Name:HOWARD, NANCY A (PT)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605
Mailing Address - Country:US
Mailing Address - Phone:978-840-1900
Mailing Address - Fax:978-840-1263
Practice Address - Street 1:135 GOLD STAR BLVD
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-856-9510
Practice Address - Fax:508-853-1907
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y69181OtherMEDICARE B
042472266OtherONE HEALTH PLAN
0329053OtherMEDICAID WELFARE
042472266OtherTHREE RIVERS
2779432OtherCIGNA HEALTH PLAN
59400OtherFALLON COMMUNITY HEALTH P
785956OtherMVP HEALTH CARE
AA4052OtherHARVARD PILGRIM HEALTHCAR
042472266OtherPRIVATE HEALTHCARE SYSTEM
MA0329053Medicaid
Y68211OtherBLUE SHIELD HMO BLUE
7404620OtherAETNA US HEALTHCARE
Y68211OtherBLUE CARE ELECT
Y68211OtherBLUE SHIELD INDEMNITY
2133873OtherFIRST HEALTH
MAY69181Medicare ID - Type Unspecified