Healthcare Provider Details

I. General information

NPI: 1730178849
Provider Name (Legal Business Name): JAY HORROW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N BROAD ST
PHILADELPHIA PA
19102-1121
US

IV. Provider business mailing address

1500 MARKET ST 24TH FLOOR-WEST TOWER
PHILADELPHIA PA
19102-2100
US

V. Phone/Fax

Practice location:
  • Phone: 215-762-7922
  • Fax: 215-762-8656
Mailing address:
  • Phone: 215-255-3828
  • Fax: 215-255-3577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD021800E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: