Provider Demographics
NPI:1124340294
Name:WERNER, MICHAEL A (MD, FACS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:WERNER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 MAMARONECK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2438
Mailing Address - Country:US
Mailing Address - Phone:914-997-4100
Mailing Address - Fax:
Practice Address - Street 1:440 MAMARONECK AVE STE 201
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2438
Practice Address - Country:US
Practice Address - Phone:914-997-4100
Practice Address - Fax:914-683-0974
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT033744208800000X
NJ61153208800000X
NY173066208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83939Medicare UPIN