MEDICARE: DR. ELISABETH HOROWITZ MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MA59283	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	460001339	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0454166	OTHER	NJ	AETNA US HEALTHCARE

General Provider Information

NPI Number	:	1952310930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISABETH HOROWITZ MD

Provider Business Mailing Address
First Line	:	4510 CHURCH RD
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-2210
Country	:	US
Telephone Number	:	856-528-2583
Fax Number	:	856-528-2585

Provider Business Practice Location Address
First Line	:	4510 CHURCH RD
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-2210
Country	:	US
Telephone Number	:	856-528-2583
Fax Number	:	856-528-2585

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	10/22/2021

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