Healthcare Provider Details

I. General information

NPI: 1184580375
Provider Name (Legal Business Name): STEVEN D WARREN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 AQUIDNECK AVE
MIDDLETOWN RI
02842-5796
US

IV. Provider business mailing address

PO BOX 411179
BOSTON MA
02241-1179
US

V. Phone/Fax

Practice location:
  • Phone: 401-414-5212
  • Fax:
Mailing address:
  • Phone: 914-294-4050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT04151
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: