Doctor Name: | WENDY S EDWARDS |
NPI Number: | 1508973256 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 176104 |
Business Practice Address: | 100 E 77th St 6 Black Hall New York, NY - 100751850 |
Business Phone Number: | 2124345218 |
Business Fax Number: | 2124342446 |
Mailing Address: | 100 E 77th St, 6 Black Hall NEW YORK |
State: | NY |
Postal Code: | 100751850 |
Phone Number: | 2124345218 |
Fax Number: | 2124342446 |
NPI Enumeration Date: | 08/25/2006 |
NPI Last Update Date: | 05/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 176104 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |