Provider Demographics
NPI:1174684013
Name:HORWITZ, ALLAN JAY (PT)
Entity Type:Individual
Prefix:MR
First Name:ALLAN
Middle Name:JAY
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 BANCROFT WAY
Mailing Address - Street 2:STE. 301
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1405
Mailing Address - Country:US
Mailing Address - Phone:510-549-2225
Mailing Address - Fax:
Practice Address - Street 1:2041 BANCROFT WAY
Practice Address - Street 2:STE 301
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1405
Practice Address - Country:US
Practice Address - Phone:510-549-2225
Practice Address - Fax:510-549-0741
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11156225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP05616Medicare ID - Type Unspecified