Provider Demographics
NPI:1477445807
Name:WERNER, CAYLA BROOKE
Entity type:Individual
Prefix:
First Name:CAYLA
Middle Name:BROOKE
Last Name:WERNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PINE HOLLOW RD APT 16-5A
Mailing Address - Street 2:
Mailing Address - City:EAST NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:11732-1034
Mailing Address - Country:US
Mailing Address - Phone:631-972-8656
Mailing Address - Fax:
Practice Address - Street 1:2249 2ND AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-2266
Practice Address - Country:US
Practice Address - Phone:212-201-1201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011239152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist