Provider Demographics
NPI:1396062121
Name:ROBERT T. HORN, JR., M.D.
Entity type:Organization
Organization Name:ROBERT T. HORN, JR., M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF BUSINESS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:HORN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:607-257-1107
Mailing Address - Street 1:2333 N TRIPHAMMER RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1082
Mailing Address - Country:US
Mailing Address - Phone:607-257-1107
Mailing Address - Fax:607-257-1869
Practice Address - Street 1:2333 N TRIPHAMMER RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1082
Practice Address - Country:US
Practice Address - Phone:607-257-1107
Practice Address - Fax:607-257-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty