Provider Demographics
NPI:1033562780
Name:HORESH, NIR (MD)
Entity Type:Individual
Prefix:DR
First Name:NIR
Middle Name:
Last Name:HORESH
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 1:1249 PARK AVE
Mailing Address - Street 2:APARTMENT 15A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-7219
Mailing Address - Country:US
Mailing Address - Phone:347-510-7931
Mailing Address - Fax:
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3625
Practice Address - Country:US
Practice Address - Phone:954-654-2023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2021-08-03
Deactivation Date:2021-01-30
Deactivation Code:
Reactivation Date:2021-07-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program