Provider Demographics
NPI:1275647174
Name:HOROWITZ, MICHAEL SIDNEY (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SIDNEY
Last Name:HOROWITZ
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 1:112 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5336
Mailing Address - Country:US
Mailing Address - Phone:973-364-1444
Mailing Address - Fax:973-364-0101
Practice Address - Street 1:112 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5336
Practice Address - Country:US
Practice Address - Phone:973-364-1444
Practice Address - Fax:973-364-0101
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02866900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD77304Medicare UPIN
NJ657692Medicare ID - Type Unspecified