Provider Demographics
NPI:1346401155
Name:HOROWITZ, ALLISON R (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:R
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRANITE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5170
Mailing Address - Country:US
Mailing Address - Phone:610-513-9952
Mailing Address - Fax:
Practice Address - Street 1:100 GRANITE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5170
Practice Address - Country:US
Practice Address - Phone:610-565-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442227208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics