Organization
FRED WARREN D.P.M.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED WARREN D.P.M.,P.C. (PRESIDENT)
(718) 261-7373
Entity
Organization
Contact information
Practice address
15274 JEWEL AVE, FLUSHING, NY 11367-1436
(718) 261-7373
(718) 261-7373
Mailing address
15274 JEWEL AVE, FLUSHING, NY 11367-1436
(718) 261-7373
(718) 261-7373
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003300
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00687554
—
NY
01
—
0079443
GHI
NY
01
—
4715140001
MEDICARE(DMEPOS)
NY
01
—
HIP00304
HIP
NY
01
—
P2790041
OXFORD
NY
01
—
P35241
EMPIRE BC/BS
NY
01
—
P53091ANDP3092
EMPIRE PPO/EPO
NY
01
—
P53092
MEDICARE(EMPIRE)
NY
Enumeration date
02/09/2011
Last updated
02/09/2011
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