1841334810 NPI number — DR. LEORA IDIT HORWITZ M.D., M.H.S.

Table of content: DR. LEORA IDIT HORWITZ M.D., M.H.S. (NPI 1841334810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841334810 NPI number — DR. LEORA IDIT HORWITZ M.D., M.H.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORWITZ
Provider First Name:
LEORA
Provider Middle Name:
IDIT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., M.H.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KAUFMAN
Provider Other First Name:
LEORA
Provider Other Middle Name:
HORWITZ
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1841334810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 1ST AVE
Provider Second Line Business Mailing Address:
TRB ROOM 607
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-6402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-501-2685
Provider Business Mailing Address Fax Number:
646-501-2706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 1ST AVE
Provider Second Line Business Practice Location Address:
TRB ROOM 607
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-6402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-501-2685
Provider Business Practice Location Address Fax Number:
646-501-2706
Provider Enumeration Date:
02/16/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  042642 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 221998 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)