MEDICARE: WENDY R. PARISH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	168520-1	NY

General Provider Information

NPI Number	:	1154510659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY R. PARISH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 16
Second Line	:
City	:	STAATSBURG
State	:	NY
Zip	:	12580-0016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 16
Second Line	:
City	:	STAATSBURG
State	:	NY
Zip	:	12580-0016
Country	:	US
Telephone Number	:	845-453-7546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2007
Last Update Date	:	08/25/2025

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