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General NPI Number Information
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NPI Number | 1497874473
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Entity Type | Individual
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Provider Name | JUDITH JORDAN WARREN PHD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 TUDOR CITY PL APT 1BS
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City | NEW YORK
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State | NY
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Zip | 10017-6800
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Country | US
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Telephone | 212-353-3475
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Fax |
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Provider Business Mailing Address
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Address Line | 2 TUDOR CITY PL APT 1BS
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City | NEW YORK
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State | NY
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Zip | 10017-6800
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Country | US
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Telephone | 212-353-3475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 013102
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License Number State | NY
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