Healthcare Provider Details

I. General information

NPI: 1578830774
Provider Name (Legal Business Name): RAYMOND PAUL WARRELL JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 11/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 KIMBALL CIR
WESTFIELD NJ
07090-1808
US

IV. Provider business mailing address

6 KIMBALL CIRCLE
WESTFIELD NJ
07090
US

V. Phone/Fax

Practice location:
  • Phone: 908-286-3965
  • Fax: 908-464-1705
Mailing address:
  • Phone: 908-286-3965
  • Fax: 908-464-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number130599
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: