Provider Demographics
NPI:1447312731
Name:HOROWITZ, TAMMY GOTLIEB (MD)
Entity type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:GOTLIEB
Last Name:HOROWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:KAREN
Other - Last Name:GOTLIEB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 E 87TH ST APT 12E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3131
Mailing Address - Country:US
Mailing Address - Phone:212-369-1790
Mailing Address - Fax:
Practice Address - Street 1:200 E 87TH ST APT 12E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3131
Practice Address - Country:US
Practice Address - Phone:212-369-1790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2246972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
424BJ1Medicare PIN
NYI10767Medicare UPIN