Provider Demographics
NPI:1275512600
Name:HOROWITZ, CAROLYN J (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:J
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3624 MARKET ST
Mailing Address - Street 2:STE. 560W UPHS-OFFICE OF MEDICAL AFFAIRS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-662-2286
Mailing Address - Fax:
Practice Address - Street 1:900 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080
Practice Address - Country:US
Practice Address - Phone:856-582-3008
Practice Address - Fax:856-582-3009
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA040892002085R0001X
PAMD030246E2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2580647OtherAETNA USHC
NJ80457OtherAMERIGROUP
NJ204378OtherUS FAMILY HEALTH PLAN
NJ2K1601OtherHEALTHNET
NJ0061886000OtherAMERIHEALTH HMO
NJ422817OtherAMERIHEALTH PPO
NJBNS021OtherOXFORD
NJ1153666OtherHORIZON/MERCY
NJ223782602OtherHORIZON BCBS
NJ1371509Medicaid
NJ920006709OtherRAILROAD MEDICARE
NJP00613893OtherRR MEDICARE
NJ1153666OtherHORIZON/MERCY
NJ422817R23Medicare PIN
NJ422817WLBMedicare PIN