Provider Demographics
NPI:1538124474
Name:WERNER, GREGORY ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALLEN
Last Name:WERNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8539
Mailing Address - Country:US
Mailing Address - Phone:212-980-2626
Mailing Address - Fax:212-308-9836
Practice Address - Street 1:164 E 61ST ST # A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8539
Practice Address - Country:US
Practice Address - Phone:212-980-2626
Practice Address - Fax:212-308-9836
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP481598OtherOXFORD
NY3647554-004OtherCIGNA
NYP481598OtherOXFORD ID #
NYU59015Medicare UPIN
NYP481598OtherOXFORD ID #
NYX5A181Medicare ID - Type Unspecified