MEDICARE: DR. ALBERT JOSEPH WERRELL 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	207R00000X	Internal Medicine Physician	1954731	NY
2	207U00000X	Nuclear Medicine Physician	1954731	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962410878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT JOSEPH WERRELL MD

Provider Business Mailing Address
First Line	:	6 PINE TREE PL
Second Line	:
City	:	WEST CALDWELL
State	:	NJ
Zip	:	07006-7328
Country	:	US
Telephone Number	:	718-336-6667
Fax Number	:	718-336-1117

Provider Business Practice Location Address
First Line	:	2222 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3338
Country	:	US
Telephone Number	:	718-336-6667
Fax Number	:	718-336-1117

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	02/21/2008

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