Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | X4356 | NY |
NPI | 1861503633 |
---|---|
Provider Name | Dr. John M. Horvath |
First Address | Melville, NY 11747-3030 |
Second Address | Melville, NY 11747-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X4356 | LICENSE (01) | NY |