Provider Demographics
NPI:1689652000
Name:HOREN, STUART M (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:M
Last Name:HOREN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MELROSE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2251
Mailing Address - Country:US
Mailing Address - Phone:860-676-1234
Mailing Address - Fax:860-676-8339
Practice Address - Street 1:5 MELROSE DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2251
Practice Address - Country:US
Practice Address - Phone:860-676-1234
Practice Address - Fax:860-676-8339
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000267Medicare ID - Type Unspecified