Provider Demographics
NPI:1225819410
Name:HOROWITZ, LUCIEN
Entity Type:Individual
Prefix:
First Name:LUCIEN
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 CALLE DEL RANCHERO NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1236
Mailing Address - Country:US
Mailing Address - Phone:505-273-9320
Mailing Address - Fax:
Practice Address - Street 1:28 STATE ROAD 382
Practice Address - Street 2:
Practice Address - City:RANCHOS DE TAOS
Practice Address - State:NM
Practice Address - Zip Code:87557-8708
Practice Address - Country:US
Practice Address - Phone:505-273-9320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT9414225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist