Provider Demographics
NPI:1679918882
Name:ENTIN, HOWARD JAY (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JAY
Last Name:ENTIN
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 1:6081 S QUEBEC ST
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4536
Mailing Address - Country:US
Mailing Address - Phone:303-721-7330
Mailing Address - Fax:720-488-6566
Practice Address - Street 1:6081 S QUEBEC ST
Practice Address - Street 2:SUITE # 200
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4536
Practice Address - Country:US
Practice Address - Phone:303-721-7330
Practice Address - Fax:720-488-6566
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00224292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry