Provider Demographics
NPI:1255119103
Name:HORWITZ, SHAUL (RN)
Entity type:Individual
Prefix:MR
First Name:SHAUL
Middle Name:
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LAKE FOREST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1304
Mailing Address - Country:US
Mailing Address - Phone:314-647-2619
Mailing Address - Fax:
Practice Address - Street 1:12 SHMUEL BAIT
Practice Address - Street 2:
Practice Address - City:JERUSALEM
Practice Address - State:ISRAEL
Practice Address - Zip Code:9103102
Practice Address - Country:IL
Practice Address - Phone:972-655-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ228082163WC0200X
NY904710163W00000X
MO2022045252163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine