Provider Demographics
NPI:1922114339
Name:HORWITZ, HOWARD D (PHD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:D
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 RT 73
Mailing Address - Street 2:RAMBLEWOOD CTR ST 12
Mailing Address - City:MT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054
Mailing Address - Country:US
Mailing Address - Phone:856-722-9772
Mailing Address - Fax:856-722-9721
Practice Address - Street 1:148 FLINTLOCK DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4124
Practice Address - Country:US
Practice Address - Phone:856-722-9772
Practice Address - Fax:732-730-9443
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100141400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
636755Medicare ID - Type Unspecified