Provider Demographics
NPI:1588738736
Name:WARNER, PAUL (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:WARNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5613
Mailing Address - Country:US
Mailing Address - Phone:845-565-2256
Mailing Address - Fax:845-565-1728
Practice Address - Street 1:77 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5613
Practice Address - Country:US
Practice Address - Phone:845-565-2256
Practice Address - Fax:845-565-1728
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor