Provider Demographics
NPI:1972661155
Name:HOROWITZ, STUART (DO)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1203
Mailing Address - Country:US
Mailing Address - Phone:516-541-9700
Mailing Address - Fax:516-798-1086
Practice Address - Street 1:99 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1203
Practice Address - Country:US
Practice Address - Phone:516-541-9700
Practice Address - Fax:516-798-1086
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
134589A73OtherHEALTH FIRST
5066OtherVYTRA
5431A1OtherBLUE CROSS BLUE SHIELD
4121374OtherAETNA
AP024OtherOXFORD
5596318OtherGHI
AA00617BOtherMDNY
201285536OtherEMPIRE
201285536OtherLOCAL 1199
201285536OtherMULTI
4C1580OtherPHS
0H380POtherHIP
201285536OtherHORIZON
NY315206Medicaid
201285536OtherMAGACARE
500563012OtherCIGNA
201285536OtherUNITED HEALTHCARE
3C7540OtherHEALTHNET
500563012OtherCIGNA
5596318OtherGHI