Healthcare Provider Details

I. General information

NPI: 1841547007
Provider Name (Legal Business Name): HORTON JAMES LEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2012
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BROADWAY DEPT OF PEDIATRICS
ELMHURST NY
11373-1329
US

IV. Provider business mailing address

7901 BROADWAY DEPT OF PEDIATRICS
ELMHURST NY
11373-1329
US

V. Phone/Fax

Practice location:
  • Phone: 718-334-3380
  • Fax:
Mailing address:
  • Phone: 718-334-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number00000000000000000000
License Number StateZZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: