Provider Demographics
NPI:1215967880
Name:WARNER, ANDREW W (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:W
Last Name:WARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1616 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1433
Mailing Address - Country:US
Mailing Address - Phone:716-835-3097
Mailing Address - Fax:716-837-4654
Practice Address - Street 1:1616 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1433
Practice Address - Country:US
Practice Address - Phone:716-835-3097
Practice Address - Fax:716-837-4654
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01885203Medicaid
NYBB0755Medicare ID - Type Unspecified
NY01885203Medicaid