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General NPI Number Information
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NPI Number | 1487890554
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Entity Type | Organization
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Legal Business Name | KENNETH HOROWITZ OD
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 927 WILLOWBROOK RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4274
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Country | US
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Telephone | 718-982-8790
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Fax | 718-982-9366
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Provider Business Mailing Address
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Address Line | 927 WILLOWBROOK RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314
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Country | US
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Telephone | 718-982-8790
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Fax | 718-982-9366
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Authorized Official
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Title or Position | DR
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Name | KENNETH HOROWITZ
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Credential | O.D.
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Telephone | 718-982-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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