Provider Demographics
NPI:1992726152
Name:MARESCA, WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:MARESCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4-14 SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-5632
Mailing Address - Country:US
Mailing Address - Phone:201-794-3987
Mailing Address - Fax:201-794-1404
Practice Address - Street 1:999 MCBRIDE AVE
Practice Address - Street 2:SUITE B204
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2570
Practice Address - Country:US
Practice Address - Phone:973-256-5667
Practice Address - Fax:973-256-7758
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA41731207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4592204Medicaid
NJ4592204Medicaid
NJ482392A3PMedicare ID - Type Unspecified