Healthcare Provider Details

I. General information

NPI: 1669891677
Provider Name (Legal Business Name): ROBIN WARNER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN PETRIZZO DO

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E 39TH ST STE 200
NEW YORK NY
10016-0455
US

IV. Provider business mailing address

8309 161ST AVE
HOWARD BEACH NY
11414-3048
US

V. Phone/Fax

Practice location:
  • Phone: 212-389-9497
  • Fax: 682-255-1158
Mailing address:
  • Phone: 718-440-5903
  • Fax: 682-255-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number284403
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: