Provider Demographics
NPI:1215633979
Name:WARNER, BINDU C
Entity type:Individual
Prefix:
First Name:BINDU
Middle Name:C
Last Name:WARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 N WALNUT ST APT 411
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017-3577
Mailing Address - Country:US
Mailing Address - Phone:704-712-3643
Mailing Address - Fax:
Practice Address - Street 1:1115 CLIFTON AVE STE 202
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3650
Practice Address - Country:US
Practice Address - Phone:973-210-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBACB561567103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst