Healthcare Provider Details

I. General information

NPI: 1912979246
Provider Name (Legal Business Name): LINDA WARNOWICZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5794 WIDEWATERS PKWY
SYRACUSE NY
13214-1845
US

IV. Provider business mailing address

5794 WIDEWATERS PKWY
SYRACUSE NY
13214-1845
US

V. Phone/Fax

Practice location:
  • Phone: 315-422-1513
  • Fax: 315-422-5890
Mailing address:
  • Phone: 315-422-1513
  • Fax: 315-422-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number182328
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: