NPI Code Detail JSON Logo

1396374708 NPI number — EUGENE PETER WARNICK III MD

NPI Number: 1396374708
Health Care Provider/Practitioner: EUGENE PETER WARNICK III MD

Information about “1396374708” NPI (EUGENE PETER WARNICK III MD) exists in 1396374708 in HTML format HTML  |  1396374708 in plain Text format TXT  |  1396374708 in PDF (Portable Document Format) PDF  |  1396374708 in an XML format XML  formats.

NPI Number : 1396374708 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396374708",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WARNICK",
    "FirstName": "EUGENE",
    "MiddleName": "PETER",
    "NamePrefix": "DR.",
    "NameSuffix": "III",
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WARNICK",
    "OtherFirstName": "GINO",
    "OtherMiddleName": "PETER",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": "III",
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "622 HEBRON AVE STE 205",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLASTONBURY",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06033-5003",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "570-301-2335",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "622 HEBRON AVE STE 205",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLASTONBURY",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06033-5003",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "860-781-6294",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/07/2020",
    "LastUpdateDate": "07/23/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": "81169",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207XS0106X",
          "TaxonomyName": "Orthopaedic Hand Surgery Physician",
          "LicenseNumber": "81169",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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