Provider Demographics
NPI:1639169048
Name:WARFEL, MARK (DO)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:WARFEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 MIDDLE SETTLEMENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-5331
Mailing Address - Country:US
Mailing Address - Phone:315-797-2398
Mailing Address - Fax:315-797-2419
Practice Address - Street 1:4401 MIDDLE SETTLEMENT RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-5331
Practice Address - Country:US
Practice Address - Phone:315-797-2398
Practice Address - Fax:315-797-2419
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180399-1207Q00000X
NY180399207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01242759Medicaid
NYE45202Medicare UPIN
NY01242759Medicaid