Provider Demographics
NPI:1952310930
Name:HOROWITZ, ELISABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2210
Mailing Address - Country:US
Mailing Address - Phone:856-528-2583
Mailing Address - Fax:856-528-2585
Practice Address - Street 1:4510 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2210
Practice Address - Country:US
Practice Address - Phone:856-528-2583
Practice Address - Fax:856-528-2585
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59283207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ460001339OtherRAILROAD MEDICARE
NJ5501601Medicaid
NJ0454166OtherAETNA US HEALTHCARE
NJT00742Medicare UPIN
NJ5501601Medicaid