Healthcare Provider Details

I. General information

NPI: 1679720635
Provider Name (Legal Business Name): WERNER NEUHAUSSER MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE
BOSTON MA
02215-5400
US

IV. Provider business mailing address

11 WYMAN ST APT 3E
BOSTON MA
02130-1981
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-2966
  • Fax:
Mailing address:
  • Phone: 646-510-4825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number250135
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: