Provider Demographics
NPI:1760403885
Name:CNS CLINICIANS, P.C.
Entity Type:Organization
Organization Name:CNS CLINICIANS, P.C.
Other - Org Name:DBA WELLESLEY NEUROLOGY GROUP, DBA CNS MULTISPECIALTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2172
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:SUITE 150
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-2172
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:2006-07-22
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
204C00000X, 204R00000X, 208100000X, 2084N0008X, 2084N0600X, 2084S0010X, 208VP0000X
MA2080602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular MedicineGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM19140OtherBLUE CROSS BLUE SHIELD