Provider Demographics
NPI:1982696365
Name:WENDY R PARISH, M.D., P.C.
Entity Type:Organization
Organization Name:WENDY R PARISH, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PARISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-331-2677
Mailing Address - Street 1:361 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-331-2677
Mailing Address - Fax:845-331-8246
Practice Address - Street 1:361 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-331-2677
Practice Address - Fax:845-331-8246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168520-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D92090Medicare UPIN