Provider Demographics
NPI:1992707293
Name:WARREN, WENDY (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:EAST WING, SUITE 402
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5287
Mailing Address - Fax:973-322-2309
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:STE 402
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5287
Practice Address - Fax:973-322-2309
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06370100207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0052876000OtherAMERIHEALTH
NJ6861709Medicaid
NJ160059361OtherRAILROAD MEDICARE
NJ8Q3351OtherEMPIRE BC/BS OF NY ID #
NJ2K2135OtherHEALTHNET ID #
NJP2039666OtherOXFORD ID #
NJ0052876000OtherAMERIHEALTH
NJ160059361OtherRAILROAD MEDICARE