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General NPI Number Information
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NPI Number | 1649941543
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Entity Type | Individual
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Provider Name | DEANNA N WARREN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 6157 LILLYPOND WAY
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City | ONTARIO
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State | NY
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Zip | 14519-8622
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Country | US
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Telephone | 585-259-6241
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Fax |
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Provider Business Mailing Address
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Address Line | 122 DREXMORE RD
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City | ROCHESTER
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State | NY
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Zip | 14610-1218
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Country | US
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Telephone | 585-402-8694
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 342459
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License Number State | NY
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