Healthcare Provider Details

I. General information

NPI: 1336234392
Provider Name (Legal Business Name): RICHARD RP WARNER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 YORK AVE
NEW YORK NY
10128-6828
US

IV. Provider business mailing address

1751 YORK AVE
NEW YORK NY
10128-6828
US

V. Phone/Fax

Practice location:
  • Phone: 212-722-2100
  • Fax: 212-831-3031
Mailing address:
  • Phone: 212-722-2100
  • Fax: 212-831-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number073140
License Number StateNY

VIII. Authorized Official

Name: DR. RICHARD RP WARNER
Title or Position: PRESIDENT
Credential: MD
Phone: 212-722-2100