Provider Demographics
NPI:1013212836
Name:HOROWITZ, MARYLIN (LP)
Entity Type:Individual
Prefix:
First Name:MARYLIN
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 94TH ST
Mailing Address - Street 2:APT 24G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7041
Mailing Address - Country:US
Mailing Address - Phone:212-662-7213
Mailing Address - Fax:
Practice Address - Street 1:41 E 11TH ST # 51
Practice Address - Street 2:4TH FLR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4602
Practice Address - Country:US
Practice Address - Phone:212-477-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000827-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst