Provider Demographics
NPI:1043904188
Name:WARNER, DANIEL MCGOWAN
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MCGOWAN
Last Name:WARNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3262
Mailing Address - Country:US
Mailing Address - Phone:718-377-5755
Mailing Address - Fax:718-377-0752
Practice Address - Street 1:1623 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3262
Practice Address - Country:US
Practice Address - Phone:718-377-5755
Practice Address - Fax:718-377-0752
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPS-P-4990175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist