Provider Demographics
NPI:1487720298
Name:WARREN FAMILY PRACTICE ASSOCIATES INC
Entity type:Organization
Organization Name:WARREN FAMILY PRACTICE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEIBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:401-247-1000
Mailing Address - Street 1:851 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:RI
Mailing Address - Zip Code:02885
Mailing Address - Country:US
Mailing Address - Phone:401-247-1000
Mailing Address - Fax:401-247-1971
Practice Address - Street 1:851 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:RI
Practice Address - Zip Code:02885
Practice Address - Country:US
Practice Address - Phone:401-247-1000
Practice Address - Fax:401-247-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty