Healthcare Provider Details

I. General information

NPI: 1346431590
Provider Name (Legal Business Name): BIRGITTA URSULA WARVAROVSKY D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PARKWAY SOUTH JACOBI MEDICAL CENTER
BRONX NY
10461-1116
US

IV. Provider business mailing address

1400 PELHAM PARKWAY SOUTH
NEW YORK NY
10461
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-4339
  • Fax:
Mailing address:
  • Phone: 718-918-6865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberN/A
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number058443
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: