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General NPI Number Information
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NPI Number | 1922274489
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Entity Type | Individual
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Provider Name | LYNETTE JOY HOROWITZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 02/26/2014
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Provider Practice Location Address
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Address Line | 5225 ROUTE 347 STE 20
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2058
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Country | US
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Telephone | 631-473-2112
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Fax | 631-743-9444
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Provider Business Mailing Address
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Address Line | 5225 ROUTE 347 STE 20
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-2058
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Country | US
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Telephone | 631-473-2112
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Fax | 631-743-9444
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 152606
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License Number State | NY
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