Healthcare Provider Details

I. General information

NPI: 1205986791
Provider Name (Legal Business Name): WENDY HELAINE MARX M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 LEXINGTON AVE SUITE 206
MOUNT KISCO NY
10549-3632
US

IV. Provider business mailing address

11 KATONAH CROSSING CT
KATONAH NY
10536-3735
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-4742
  • Fax: 914-666-4850
Mailing address:
  • Phone: 914-232-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number190215
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: