Provider Demographics
NPI:1366614638
Name:SCOTT M HORWITZ DPM
Entity type:Organization
Organization Name:SCOTT M HORWITZ DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:HORWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:617-254-1344
Mailing Address - Street 1:280 WASHINGTON ST
Mailing Address - Street 2:SUITE #304A
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3511
Mailing Address - Country:US
Mailing Address - Phone:617-254-1344
Mailing Address - Fax:617-783-4803
Practice Address - Street 1:280 WASHINGTON ST
Practice Address - Street 2:SUITE #304A
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3511
Practice Address - Country:US
Practice Address - Phone:617-254-1344
Practice Address - Fax:617-783-4803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0361666Medicaid
MA5135420001OtherMEDICARE DME
MAT58780Medicare UPIN
MA0361666Medicaid