MEDICARE: YANA WARSHAWSKY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	26NJ15180000	NJ

General Provider Information

NPI Number	:	1609697937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANA WARSHAWSKY

Provider Business Mailing Address
First Line	:	275 DUNHAM PL
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-1229
Country	:	US
Telephone Number	:	917-753-4071
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 DUNHAM PL
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-1229
Country	:	US
Telephone Number	:	917-753-4071
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2024
Last Update Date	:	10/19/2024

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Directions to “ YANA WARSHAWSKY ” Practice Location

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