Provider Demographics
NPI:1376918540
Name:CNS CLINICIANS, PC
Entity Type:Organization
Organization Name:CNS CLINICIANS, PC
Other - Org Name:CNS MULTISPECIALTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:Q
Authorized Official - Last Name:WARINNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-237-0070
Mailing Address - Street 1:65 WALNUT ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2118
Mailing Address - Country:US
Mailing Address - Phone:781-237-0070
Mailing Address - Fax:781-237-0090
Practice Address - Street 1:65 WALNUT ST
Practice Address - Street 2:SUITE150
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-2118
Practice Address - Country:US
Practice Address - Phone:781-237-0070
Practice Address - Fax:781-237-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21841OtherMEDICARE PTAN