Healthcare Provider Details

I. General information

NPI: 1528061983
Provider Name (Legal Business Name): WENDY A ANGELO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1037 MAIN ST
PEEKSKILL NY
10566-2913
US

IV. Provider business mailing address

PO BOX 5036
WHITE PLAINS NY
10602-5036
US

V. Phone/Fax

Practice location:
  • Phone: 914-734-8800
  • Fax: 845-765-9406
Mailing address:
  • Phone: 845-745-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48304
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10892
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD056517L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number335159
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: