Provider Demographics
NPI:1942986609
Name:WARREN, JONATHAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BAYLIS CT APT 2S
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-7671
Mailing Address - Country:US
Mailing Address - Phone:917-664-3975
Mailing Address - Fax:
Practice Address - Street 1:13 BAYLIS CT APT 2S
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-7671
Practice Address - Country:US
Practice Address - Phone:917-664-3975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist