Provider Demographics
NPI:1225023351
Name:WARNER, RICHARD T (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:T
Last Name:WARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 550, 2 CATHARINE STREET
Mailing Address - Street 2:CATSKILL ANESTHESIC ASSOCIATES, LLP
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12602
Mailing Address - Country:US
Mailing Address - Phone:866-885-2318
Mailing Address - Fax:860-282-0170
Practice Address - Street 1:10 HEALTHY WAY, RTE 209
Practice Address - Street 2:ELLENVILLE REGIONAL HOSPITAL
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-5612
Practice Address - Country:US
Practice Address - Phone:895-647-6400
Practice Address - Fax:860-282-0170
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT031501207L00000X
NY175840-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001315010Medicaid
CT001315010Medicaid
CT050001013Medicare ID - Type Unspecified