| Organization Name: | WARREN PEDIATRICS, LLC |
| NPI Number: | 1043451214 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW SCOTT WARREN (MEMBER) |
| Mailing Address: | 81 S Main St Ste 5 West Hartford |
| State: | CT US |
| Postal Code: | 061072400 |
| Phone Number: | 8605214044 |
| Fax Number: | 8605213885 |
| NPI Enumeration Date: | 03/17/2009 |
| NPI Last Update Date: | 07/23/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |