Provider Demographics
NPI:1497701262
Name:MANKO, WENDY S (DO)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:S
Last Name:MANKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:325 CENTRAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3265
Mailing Address - Country:US
Mailing Address - Phone:610-251-9433
Mailing Address - Fax:610-251-9539
Practice Address - Street 1:325 CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3265
Practice Address - Country:US
Practice Address - Phone:610-251-9433
Practice Address - Fax:610-251-2580
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010454L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH95538Medicare UPIN
PA1564913Medicare ID - Type UnspecifiedMEDICARE NUMBER