Provider Demographics
NPI:1760877674
Name:WARREN, LINDSAY (MD (MAY 11, 2015))
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:MD (MAY 11, 2015)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PAMELA PL
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-3710
Mailing Address - Country:US
Mailing Address - Phone:203-858-7919
Mailing Address - Fax:
Practice Address - Street 1:10 PAMELA PL
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3710
Practice Address - Country:US
Practice Address - Phone:203-858-7919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA162334207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program