Individual
MR. MICHAEL LEONARD WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1600 MACOMBS RD, BRONX, NY 10452-2016
(718) 299-3300
(718) 294-5189
Mailing address
15 WHITE GATE DR APT L, WAPPINGERS FALLS, NY 12590-5068
(347) 750-3564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215
—
NY
Enumeration date
12/29/2017
Last updated
06/16/2018
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