Healthcare Provider Details

I. General information

NPI: 1558273185
Provider Name (Legal Business Name): BLAKE WERNER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SHUNPIKE RD
CROMWELL CT
06416-1143
US

IV. Provider business mailing address

165 SHUNPIKE RD
CROMWELL CT
06416-1143
US

V. Phone/Fax

Practice location:
  • Phone: 203-665-8988
  • Fax: 203-665-8988
Mailing address:
  • Phone: 203-665-8988
  • Fax: 203-665-8988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT BLAKE WERNER JR.
Title or Position: OWNER
Credential: MD
Phone: 203-665-8988