Individual
MARK A WERNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,PA-C
Contact information
Practice address
1051 CRAFT RD, ITHACA, NY 14850-1016
(607) 257-1107
(607) 257-0369
Mailing address
274 CHIPMAN CORNERS RD, GROTON, NY 13073-8405
(609) 351-4567
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
019675-1
NY
363AM0700X
Medical Physician Assistant
25MP00163400
NJ
Other
Enumeration date
08/14/2006
Last updated
02/08/2023
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