Provider Demographics
NPI:1669891677
Name:WARNER, ROBIN (DO)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:PETRIZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:8309 161ST AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3048
Mailing Address - Country:US
Mailing Address - Phone:718-440-5903
Mailing Address - Fax:682-255-1158
Practice Address - Street 1:6 E 39TH ST STE 200
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0455
Practice Address - Country:US
Practice Address - Phone:212-389-9497
Practice Address - Fax:682-255-1158
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2844032084N0008X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05060893Medicaid