Doctor Name: | DR. MATTHEW FISKE WARREN |
NPI Number: | 1760624241 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 248619 |
Business Practice Address: | 760 Broadway. Woodhull Medical & Mental Health Center Brooklyn, NY - 11206 |
Business Phone Number: | 7189638000 |
Business Fax Number: | 7186303122 |
Mailing Address: | 760 Broadway Department Of Managed Care Rm 2b230., Woodhull Medical & Mental Health Center. BROOKLYN |
State: | NY |
Postal Code: | 11206 |
Phone Number: | 7189638000 |
Fax Number: | 7186303122 |
NPI Enumeration Date: | 03/31/2009 |
NPI Last Update Date: | 04/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 248619 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |