Provider Demographics
NPI:1699982793
Name:ISLAND OBSTETRICS AND GYNECOLOGY
Entity type:Organization
Organization Name:ISLAND OBSTETRICS AND GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-668-1700
Mailing Address - Street 1:27 NEW DORP LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2349
Mailing Address - Country:US
Mailing Address - Phone:718-668-1700
Mailing Address - Fax:718-668-1733
Practice Address - Street 1:27 NEW DORP LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2349
Practice Address - Country:US
Practice Address - Phone:718-668-1700
Practice Address - Fax:718-668-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185682174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty