MEDICARE: WENDY BROWN-MAGETT

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	302R00000X	Health Maintenance Organization

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	171M00000X	OTHER	NY	CASE MANAGER/CARE COORDINATOR

General Provider Information

NPI Number	:	1215337027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY BROWN-MAGETT

Provider Business Mailing Address
First Line	:	5800 ARLINGTON AVE
Second Line	:	BRONX
City	:	BRONX
State	:	NY
Zip	:	10471-1402
Country	:	US
Telephone Number	:	212-470-6557
Fax Number	:	347-326-7430

Provider Business Practice Location Address
First Line	:	5800 ARLINGTON AVE
Second Line	:	BRONX
City	:	BRONX
State	:	NY
Zip	:	10471-1402
Country	:	US
Telephone Number	:	212-470-6557
Fax Number	:	347-326-7430

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

Provider Enumeration Date	:	08/28/2014
Last Update Date	:	09/10/2014

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Directions to “ WENDY BROWN-MAGETT ” Practice Location

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