Provider Demographics
NPI:1013943901
Name:HOROWITZ, ALYSSA (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
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 1:971 ROUTE 202 N
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3757
Mailing Address - Country:US
Mailing Address - Phone:908-429-0044
Mailing Address - Fax:908-429-4228
Practice Address - Street 1:971 ROUTE 202 N
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3757
Practice Address - Country:US
Practice Address - Phone:908-429-0044
Practice Address - Fax:908-429-4228
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA062376174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG09508Medicare UPIN