Provider Demographics
NPI:1861485641
Name:HOROWITZ, EMIL R (OD)
Entity Type:Individual
Prefix:DR
First Name:EMIL
Middle Name:R
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 VFW PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-5500
Mailing Address - Country:US
Mailing Address - Phone:617-327-2200
Mailing Address - Fax:
Practice Address - Street 1:38 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-2021
Practice Address - Country:US
Practice Address - Phone:781-899-4447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2668152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU33728Medicare UPIN