MEDICARE: DEBRA J WERNER 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
1	207VG0400X	Gynecology Physician	185682	NY

General Provider Information

NPI Number	:	1760577258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA J WERNER MD

Provider Business Mailing Address
First Line	:	83 WESTMINSTER CT
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-1313
Country	:	US
Telephone Number	:	718-668-1700
Fax Number	:	718-668-1733

Provider Business Practice Location Address
First Line	:	27 NEW DORP LN STE 2
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-2314
Country	:	US
Telephone Number	:	718-668-1700
Fax Number	:	718-668-1733

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	05/09/2024

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