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NPI Code Detail

MEDICARE: CHRISTIAN WERTENBAKER MD

MEDICARE:   CHRISTIAN  WERTENBAKER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician121279NY

General Provider Information

NPI Number : 1083795413
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN WERTENBAKER MD
Provider Business Mailing Address
First Line : 379 CITY ISLAND AVE
Second Line :
City : BRONX
State : NY
Zip : 10464-1300
Country : US
Telephone Number : 718-920-5561
Fax Number :
Provider Business Practice Location Address
First Line : MMC-DEPT. OF OPHTHALMOLOGY
Second Line : 3400 BAINBRIDGE AVENUE
City : BRONX
State : NY
Zip : 10467
Country : US
Telephone Number : 718-920-5561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 07/08/2007

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Directions to “ CHRISTIAN WERTENBAKER MD” Practice Location

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