Provider Demographics
NPI:1922557289
Name:WARSHAY, GARRETT
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:
Last Name:WARSHAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2933
Mailing Address - Country:US
Mailing Address - Phone:585-484-0705
Mailing Address - Fax:
Practice Address - Street 1:877 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2933
Practice Address - Country:US
Practice Address - Phone:585-484-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2021-10-21
Deactivation Date:2021-06-24
Deactivation Code:
Reactivation Date:2021-07-09
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY024372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health