Healthcare Provider Details

I. General information

NPI: 1700854809
Provider Name (Legal Business Name): SUSANNA E HORVATH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 DULLES CORNER PARK STE 475
HERNDON VA
20171-5605
US

IV. Provider business mailing address

2411 DULLES CORNER PARK STE 475
HERNDON VA
20171-5605
US

V. Phone/Fax

Practice location:
  • Phone: 800-762-9244
  • Fax: 786-672-6006
Mailing address:
  • Phone: 800-762-9244
  • Fax: 786-672-6006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number003239
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number253243-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: