Provider Demographics
NPI:1114330644
Name:WERNER, TATIARA ALEXANDRA (DO)
Entity Type:Individual
Prefix:DR
First Name:TATIARA
Middle Name:ALEXANDRA
Last Name:WERNER
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Gender:F
Credentials:DO
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Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:2280 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-2911
Practice Address - Country:US
Practice Address - Phone:631-698-7828
Practice Address - Fax:631-698-3300
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2019-12-06
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Provider Licenses
StateLicense IDTaxonomies
NY292019207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine