Healthcare Provider Details

I. General information

NPI: 1689672339
Provider Name (Legal Business Name): ANDREW J WARCHOL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SEAVIEW AVE STE 300
STATEN ISLAND NY
10305-3436
US

IV. Provider business mailing address

501 SEAVIEW AVE STE 300
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 718-663-7000
  • Fax: 718-663-7090
Mailing address:
  • Phone: 718-663-7000
  • Fax: 718-663-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number187171
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: