Provider Demographics
NPI:1619106481
Name:DWYER-WARREN, CATHERINE M (LPN)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:M
Last Name:DWYER-WARREN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 HIGH ST
Mailing Address - Street 2:#2G
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-3212
Mailing Address - Country:US
Mailing Address - Phone:914-301-0132
Mailing Address - Fax:
Practice Address - Street 1:87 HIGH ST.
Practice Address - Street 2:2G
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703
Practice Address - Country:US
Practice Address - Phone:914-391-0132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296347-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse