Provider Demographics
NPI:1104981679
Name:HAMMERSCHLAG, WARREN A (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:A
Last Name:HAMMERSCHLAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MADISON AVE
Mailing Address - Street 2:SUITE
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2734
Mailing Address - Country:US
Mailing Address - Phone:201-977-6960
Mailing Address - Fax:201-977-6961
Practice Address - Street 1:22 MADISON AVE
Practice Address - Street 2:SUITE
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2734
Practice Address - Country:US
Practice Address - Phone:201-977-6960
Practice Address - Fax:201-977-6961
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05170900207X00000X
NY1572891207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7988401Medicaid
NJ7988401Medicaid
NJ537937Medicare ID - Type Unspecified