Provider Demographics
NPI:1275771073
Name:HOROWITZ, MIRIAM A (RD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:A
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 ARBUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2702
Mailing Address - Country:US
Mailing Address - Phone:516-812-6088
Mailing Address - Fax:516-812-6088
Practice Address - Street 1:622 ARBUCKLE AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2702
Practice Address - Country:US
Practice Address - Phone:516-812-6088
Practice Address - Fax:516-812-6088
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric