Provider Demographics
NPI:1972010288
Name:WARREN, JOSHUA (MAOM)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WARREN
Suffix:
Gender:M
Credentials:MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MILES ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3212
Mailing Address - Country:US
Mailing Address - Phone:413-768-7093
Mailing Address - Fax:
Practice Address - Street 1:14 MILES ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3212
Practice Address - Country:US
Practice Address - Phone:413-768-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA295605171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist