Provider Demographics
NPI:1336289859
Name:WERDER, BRIAN FRANCIS (DOCTOR OF CHIROPRACT)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:FRANCIS
Last Name:WERDER
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2862
Mailing Address - Country:US
Mailing Address - Phone:716-834-7974
Mailing Address - Fax:
Practice Address - Street 1:481 ENGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14223-2862
Practice Address - Country:US
Practice Address - Phone:716-834-7974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0042421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T25936Medicare UPIN
NY006551Medicare ID - Type Unspecified