Provider Demographics
NPI:1174558225
Name:WERNER, ROBERT LAWRENCE (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LAWRENCE
Last Name:WERNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:16 SCHOOLEYS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-6223
Mailing Address - Country:US
Mailing Address - Phone:908-777-1379
Mailing Address - Fax:803-205-2432
Practice Address - Street 1:16 SCHOOLEYS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-6223
Practice Address - Country:US
Practice Address - Phone:908-777-1379
Practice Address - Fax:803-205-2432
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB41143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
222598231OtherRR MEDICARE
222598231OtherFEDERAL BCBS
222598231OtherBCBS OF NJ&NY
222598231OtherRR MEDICARE
WE434049Medicare ID - Type Unspecified