MEDICARE: MR. MICHAEL S HORN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	023739	NY

General Provider Information

NPI Number	:	1578747838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL S HORN

Provider Business Mailing Address
First Line	:	420 SOUTH BROADWAY
Second Line	:
City	:	YONERS
State	:	NY
Zip	:	10705
Country	:	US
Telephone Number	:	914-963-1705
Fax Number	:	914-963-0512

Provider Business Practice Location Address
First Line	:	420 S BROADWAY
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10705-2301
Country	:	US
Telephone Number	:	914-963-1705
Fax Number	:	914-963-0512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2007
Last Update Date	:	12/21/2007

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Directions to “ MR. MICHAEL S HORN ” Practice Location

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