Provider Demographics
NPI:1255788527
Name:HORINE, STORM (MD)
Entity type:Individual
Prefix:DR
First Name:STORM
Middle Name:
Last Name:HORINE
Suffix:
Gender:M
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:GPO BOX 27578
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-7578
Mailing Address - Country:US
Mailing Address - Phone:844-268-4820
Mailing Address - Fax:631-201-3179
Practice Address - Street 1:429 E 75TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3102
Practice Address - Country:US
Practice Address - Phone:212-606-1206
Practice Address - Fax:212-517-4481
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303501207LP2900X, 207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology