Individual
DR. JOHN JOSEPH WERNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
2000 DEER PARK AVE, BOX 326, DEER PARK, NY 11729-2701
(631) 667-3667
Mailing address
31 RIDGEFIELD RD, CENTERPORT, NY 11721-1505
(631) 757-2351
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
008490
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008490
LICENSE NUMBER
NY
05
—
00926036
—
NY
Enumeration date
12/29/2006
Last updated
07/08/2007
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