MEDICARE: THERESA HORVATH PA-C

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	363A00000X	Physician Assistant	002320-1	NY

General Provider Information

NPI Number	:	1699168302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA HORVATH PA-C

Provider Business Mailing Address
First Line	:	160 CONVENT AVE STE 15
Second Line	:	SOPHIE DAVIS SCHOOL OF BIOMEDICAL EDUCAITON
City	:	NEW YORK
State	:	NY
Zip	:	10031-9101
Country	:	US
Telephone Number	:	212-650-6863
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 CONVENT AVE
Second Line	:	HARRIS HAL SUITE 15
City	:	NEW YORK
State	:	NY
Zip	:	10031-9101
Country	:	US
Telephone Number	:	212-650-6863
Fax Number	:

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

Provider Enumeration Date	:	03/05/2015
Last Update Date	:	03/05/2015

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