Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1144463860 |
---|---|
Provider Name | Mr. Marc E Werner |
First Address | West Babylon, NY 11704-5925 |
Second Address | West Babylon, NY 11704-5925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 10/04/2009 |