Healthcare Provider Details

I. General information

NPI: 1780642371
Provider Name (Legal Business Name): STEPHEN WARMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10721 QUEENS BLVD
FOREST HILLS NY
11375-4451
US

IV. Provider business mailing address

55-28 MAIN ST
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 718-575-3322
  • Fax: 718-268-1920
Mailing address:
  • Phone: 718-445-5100
  • Fax: 718-886-7466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number167615
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: