Provider Demographics
NPI:1740434539
Name:WARMBIER, EILEEN C (MS,PT)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:C
Last Name:WARMBIER
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:C
Other - Last Name:GLOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,PT
Mailing Address - Street 1:31 RAVENHURST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2631
Mailing Address - Country:US
Mailing Address - Phone:917-837-3647
Mailing Address - Fax:
Practice Address - Street 1:31 RAVENHURST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2631
Practice Address - Country:US
Practice Address - Phone:917-837-3647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018176-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics