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General NPI Number Information
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NPI Number | 1639409600
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Entity Type | Individual
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Provider Name | GARRY MARC WERNER LCSW-P
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Gender | Male
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 59 LAWRENCE STREET
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1752
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Country | US
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Telephone | 516-659-4093
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Fax | 516-328-7236
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Provider Business Mailing Address
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Address Line | 59 LAWRENCE STREET
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1752
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Country | US
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Telephone | 516-659-4093
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Fax | 516-328-7236
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P065154-1
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License Number State | NY
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