Provider Demographics
NPI:1689784894
Name:HORVITZ, STEVEN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PAUL
Last Name:HORVITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:PAUL
Other - Last Name:HORVITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:128 BORTONS LANDING RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3011
Mailing Address - Country:US
Mailing Address - Phone:856-231-0590
Mailing Address - Fax:856-231-1228
Practice Address - Street 1:128 BORTONS LANDING RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3011
Practice Address - Country:US
Practice Address - Phone:856-231-0590
Practice Address - Fax:856-231-1228
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06034600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6198406Medicaid
NJ6198406Medicaid
H0092028Medicare ID - Type Unspecified