Healthcare Provider Details

I. General information

NPI: 1598344236
Provider Name (Legal Business Name): MICHAEL THOMAS WERNER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L. LEVY PLACE
NEW YORK NY
10029-5674
US

IV. Provider business mailing address

1 GUSTAVE L. LEVY PLACE
NEW YORK NY
10029-5674
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6500
  • Fax:
Mailing address:
  • Phone: 212-241-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number343960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: