Individual
DR. PATRICIA R. BURRIS-WARMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7889
(631) 454-4163
Mailing address
14601 45TH AVE STE 140, FLUSHING, NY 11355-2200
(718) 670-5534
(718) 670-3031
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
198810
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01777462
—
NY
01
—
NYS LICENSE
198810
NY
Enumeration date
11/15/2006
Last updated
02/21/2014
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