Provider Demographics
NPI:1649328154
Name:WARNAGIRIS, THERESA (DC)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:WARNAGIRIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WATERLOO RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STANHOPE
Mailing Address - State:NJ
Mailing Address - Zip Code:07874-2653
Mailing Address - Country:US
Mailing Address - Phone:973-691-3300
Mailing Address - Fax:973-691-9313
Practice Address - Street 1:4 WATERLOO RD
Practice Address - Street 2:SUITE 4
Practice Address - City:STANHOPE
Practice Address - State:NJ
Practice Address - Zip Code:07874-2653
Practice Address - Country:US
Practice Address - Phone:973-691-3300
Practice Address - Fax:973-691-9313
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00273100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ536601Medicare PIN