Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 001787 | MA |
Y | 222Z00000X | Podiatrist | 001787 | MA |
NPI | 1003802133 |
---|---|
Provider Name | Dr. Scott M Horwitz |
First Address | Brighton, MA 02135-3511 |
Second Address | Brighton, MA 02135-3511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 03/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0361666 | (05) | MA |
T58780 | (02) |