Provider Demographics
NPI:1508837253
Name:HORENSTEIN, MARCELO GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:GABRIEL
Last Name:HORENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 QUEENS PLZ N FL 10
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4022
Mailing Address - Country:US
Mailing Address - Phone:844-337-6362
Mailing Address - Fax:646-665-3604
Practice Address - Street 1:60 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044
Practice Address - Country:US
Practice Address - Phone:973-571-2121
Practice Address - Fax:973-571-2126
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07813600207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087310NR4Medicare ID - Type Unspecified
NJ033830Medicare ID - Type UnspecifiedGROUP
G83597Medicare UPIN