Provider Demographics
NPI:1417409657
Name:HOROWITZ, MICHELLE HADAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HADAS
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TAMMY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1318
Mailing Address - Country:US
Mailing Address - Phone:347-884-5093
Mailing Address - Fax:
Practice Address - Street 1:208 E ROUTE 59
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5268
Practice Address - Country:US
Practice Address - Phone:845-352-7865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20062479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist