1467548446 NPI number — DR. ANN C HORWITZ ED.D.

Table of content: DR. ANN C HORWITZ ED.D. (NPI 1467548446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467548446 NPI number — DR. ANN C HORWITZ ED.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORWITZ
Provider First Name:
ANN
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467548446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
61 WALNUT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02476-6151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-354-0204
Provider Business Mailing Address Fax Number:
866-788-7789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
545 CONCORD AVE
Provider Second Line Business Practice Location Address:
SUITE 20
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02138-1125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-354-0204
Provider Business Practice Location Address Fax Number:
866-788-7789
Provider Enumeration Date:
10/05/2006

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: 103TC1900X , with the licence number:  6092 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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