Provider Demographics
NPI:1235244450
Name:WARHAFTIG, MONICA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:WARHAFTIG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:WARHAFTIG
Other - Last Name:ROSSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:452 PERKINS EXTD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-3802
Mailing Address - Country:US
Mailing Address - Phone:901-888-2646
Mailing Address - Fax:901-888-2647
Practice Address - Street 1:452 PERKINS EXTD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-3802
Practice Address - Country:US
Practice Address - Phone:901-888-2646
Practice Address - Fax:901-888-2647
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLOS8294207QG0300X
TN2284207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I086669Medicare PIN