Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 180399-1 | NY |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 180399 | NY |
NPI | 1639169048 |
---|---|
Provider Name | Mark Warfel |
First Address | New Hartford, NY 13413-5331 |
Second Address | New Hartford, NY 13413-5331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 06/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01242759 | (05) | NY |
E45202 | (02) | NY |