Provider Demographics
NPI:1083610455
Name:WERBER, JOSH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSH
Middle Name:
Last Name:WERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 NORTHERN BLVD
Mailing Address - Street 2:STE 260
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5320
Mailing Address - Country:US
Mailing Address - Phone:516-829-3466
Mailing Address - Fax:516-829-4201
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:STE 260
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5320
Practice Address - Country:US
Practice Address - Phone:516-829-3466
Practice Address - Fax:516-829-4201
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168126207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY39F371Medicare ID - Type Unspecified