Provider Demographics
NPI:1013227578
Name:WARSHAW, DARA B (LMT)
Entity Type:Individual
Prefix:MRS
First Name:DARA
Middle Name:B
Last Name:WARSHAW
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LINDA LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1009
Mailing Address - Country:US
Mailing Address - Phone:516-729-2621
Mailing Address - Fax:
Practice Address - Street 1:300 WILLETTS LN
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4619
Practice Address - Country:US
Practice Address - Phone:516-729-2621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist