Healthcare Provider Details

I. General information

NPI: 1487397311
Provider Name (Legal Business Name): RAQUEL EVELYN HOROWITZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 E FORDHAM RD
BRONX NY
10458-5015
US

IV. Provider business mailing address

889 BOULEVARD APT A
NEW MILFORD NJ
07646-2299
US

V. Phone/Fax

Practice location:
  • Phone: 347-590-0660
  • Fax:
Mailing address:
  • Phone: 201-668-7439
  • Fax: 336-975-8748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number25MA12825200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number339468-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: