Provider Demographics
NPI:1659850634
Name:HOROWITZ, JAY (PHARMACIST, RPH)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:PHARMACIST, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-6227
Mailing Address - Country:US
Mailing Address - Phone:908-406-1595
Mailing Address - Fax:
Practice Address - Street 1:1370 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6227
Practice Address - Country:US
Practice Address - Phone:212-928-1999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist