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General NPI Number Information
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NPI Number | 1942735659
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Entity Type | Individual
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Provider Name | SAMUEL WERNER D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 342 N MAIN ST STE 350
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2500
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Country | US
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Telephone | 860-331-3016
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Fax | 860-331-3019
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Provider Business Mailing Address
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Address Line | 342 N MAIN ST STE 350
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City | WEST HARTFORD
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State | CT
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Zip | 06117-2500
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Country | US
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Telephone | 860-331-3016
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Fax | 860-331-3019
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 71101
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 25MB11231200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MB11231200
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT017661
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71101
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License Number State | CT
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