Provider Demographics
NPI:1104811546
Name:WERNER, LINDA S (MD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:WERNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 TECHNOLOGY DR UNIT C101
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6300
Mailing Address - Country:US
Mailing Address - Phone:203-372-7200
Mailing Address - Fax:203-374-1473
Practice Address - Street 1:115 TECHNOLOGY DR UNIT C101
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6300
Practice Address - Country:US
Practice Address - Phone:203-372-7200
Practice Address - Fax:203-374-1473
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035232207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0865017OtherCIGNA PROVIDER ID
CT3714960OtherAETNA PROVIDER ID
CT010035232CT02OtherANTHEM PROVIDER ID
CTP00211254OtherMEDICARE RAILROAD #
CT2V5413OtherHNET PROVIDER ID
CT721835OtherCONNECTICARE PROVIDER ID
CT001352327Medicaid
CT010035232CT02OtherANTHEM BC FAMILY
CTP404869OtherOXFORD PROVIDER ID
CT3714960OtherAETNA PROVIDER ID
CT010035232CT02OtherANTHEM PROVIDER ID