Provider Demographics
NPI:1801893516
Name:HOROWITZ, PHILIP (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:HOROWITZ
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 1:509 S LENOLA RD
Mailing Address - Street 2:STE 11
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1556
Mailing Address - Country:US
Mailing Address - Phone:856-234-0222
Mailing Address - Fax:856-727-9518
Practice Address - Street 1:509 S LENOLA RD
Practice Address - Street 2:STE 11
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1556
Practice Address - Country:US
Practice Address - Phone:856-234-0222
Practice Address - Fax:856-727-9518
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02490100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1811100Medicaid
NJ1811100Medicaid
NJC60827Medicare UPIN
NJ63688BK7Medicare PIN