Healthcare Provider Details

I. General information

NPI: 1700671997
Provider Name (Legal Business Name): WOUND PROS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TECH CENTER PKWY STE 200-82
NEWPORT NEWS VA
23606-3075
US

IV. Provider business mailing address

612 CORPORATE WAY STE 2M
VALLEY COTTAGE NY
10989-2027
US

V. Phone/Fax

Practice location:
  • Phone: 757-508-5662
  • Fax:
Mailing address:
  • Phone: 718-362-1411
  • Fax: 718-362-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. ADRIENE L NEWBY
Title or Position: MANAGING MEMBER
Credential:
Phone: 845-996-8176