Provider Demographics
NPI:1992847222
Name:HOROWITZ, ELLIOTT M (RD, CSCS, CES)
Entity Type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:M
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:RD, CSCS, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 KEMPS LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-4838
Mailing Address - Country:US
Mailing Address - Phone:703-622-2321
Mailing Address - Fax:
Practice Address - Street 1:12030 KEMPS LANDING CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-4838
Practice Address - Country:US
Practice Address - Phone:703-622-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered