Provider Demographics
NPI:1508167347
Name:HOROWITZ, ILANA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:ILANA
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 GREENWOOD AVE
Mailing Address - Street 2:APT 2T
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1349
Mailing Address - Country:US
Mailing Address - Phone:917-623-9108
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:PSYCH UNIT 5, RM 5C-321
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5317
Practice Address - Country:US
Practice Address - Phone:718-963-8936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073909-1282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital