Provider Demographics
NPI:1538680715
Name:HOROWITZ, CHAVA
Entity Type:Individual
Prefix:
First Name:CHAVA
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6005
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-9005
Mailing Address - Country:US
Mailing Address - Phone:917-400-7791
Mailing Address - Fax:
Practice Address - Street 1:70-50 AUSTIN STREET
Practice Address - Street 2:LL114
Practice Address - City:LONG ISLAND
Practice Address - State:NY
Practice Address - Zip Code:11788-9005
Practice Address - Country:US
Practice Address - Phone:631-366-3876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
026490235Z00000X
NY026490235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist