Provider Demographics
NPI:1861583783
Name:HOROWITZ, NINA RUTH (MD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:RUTH
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:46 PRINCE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1600
Mailing Address - Country:US
Mailing Address - Phone:203-562-3577
Mailing Address - Fax:203-782-6864
Practice Address - Street 1:46 PRINCE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1600
Practice Address - Country:US
Practice Address - Phone:203-562-3577
Practice Address - Fax:203-782-6864
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT024348208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01243484Medicaid
CT020000480Medicare PIN
B38869Medicare UPIN