Basic Information
| Provider Information | |||||||||
| NPI: | 1972661155 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOROWITZ | ||||||||
| FirstName: | STUART | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | MASSAPEQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117581203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165419700 | ||||||||
| FaxNumber: | 5167981086 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | MASSAPEQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117581203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165419700 | ||||||||
| FaxNumber: | 5167981086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 05/16/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 134589 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 134589A73 | 01 | HEALTH FIRST | OTHER | 5066 | 01 | VYTRA | OTHER | 5431A1 | 01 | BLUE CROSS BLUE SHIELD | OTHER | 4121374 | 01 | AETNA | OTHER | AP024 | 01 | OXFORD | OTHER | 5596318 | 01 | GHI | OTHER | AA00617B | 01 | MDNY | OTHER | 201285536 | 01 | EMPIRE | OTHER | 201285536 | 01 | LOCAL 1199 | OTHER | 201285536 | 01 | MULTI | OTHER | 4C1580 | 01 | PHS | OTHER | 0H380P | 01 | HIP | OTHER | 201285536 | 01 | HORIZON | OTHER | 315206 | 05 | NY | MEDICAID | 201285536 | 01 | MAGACARE | OTHER | 500563012 | 01 | CIGNA | OTHER | 201285536 | 01 | UNITED HEALTHCARE | OTHER | 3C7540 | 01 | HEALTHNET | OTHER |