Healthcare Provider Details

I. General information

NPI: 1396374708
Provider Name (Legal Business Name): EUGENE PETER WARNICK III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GINO PETER WARNICK III MD

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3794 HECKTOWN RD STE 130
EASTON PA
18045-2355
US

IV. Provider business mailing address

2100 MACK BLVD FL 4
ALLENTOWN PA
18103-5622
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-8900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number81169
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD496072
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number81169
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: