Most Relevant Information
Provider Data
| NPI Number: | 1003655853 |
| Provider Name: | LOGAN ALEXIS WERNER MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2024 |
| Last Updated: | 05/22/2024 |
Provider Practice Location
550 1ST AVE
NEW YORK
NY
100166402
Practice Location Phone/Fax
| Phone: | 2122635506 |
| Fax: |
Provider Mailing Location
2104 OLIVER WAY
MERRICK
NY
115665426
Provider Mailing Phone/Fax
| Phone: | 5164253046 |
| Fax: |