=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760732382
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CONTRINA WARREN A.P.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2012
-----------------------------------------------------
Last Update Date | 05/03/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13 ROBERTS DR
-----------------------------------------------------
City | NEPTUNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07753-3217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-922-6212
-----------------------------------------------------
Fax | 888-773-6420
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13 ROBERTS DR
-----------------------------------------------------
City | NEPTUNE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07753-3217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-513-3433
-----------------------------------------------------
Fax | 888-773-6420
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 337577
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------