Provider Demographics
NPI:1154045300
Name:HORIZONDOC, PC
Entity type:Organization
Organization Name:HORIZONDOC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-803-1176
Mailing Address - Street 1:PO BOX 110055
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-0901
Mailing Address - Country:US
Mailing Address - Phone:201-803-1176
Mailing Address - Fax:
Practice Address - Street 1:900 AVE AT PORT IMPERIAL BLVD APT 1018
Practice Address - Street 2:
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-6112
Practice Address - Country:US
Practice Address - Phone:201-803-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1093177503OtherINDIVIDUAL NPI NUMBER