MEDICARE: WENDY ANNE DEMARTINO MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	MD23528	ME
2	207P00000X	Emergency Medicine Physician	042.0015002	VT
3	207P00000X	Emergency Medicine Physician	MD469629	PA
4	207P00000X	Emergency Medicine Physician	NH16303	NH
5	207P00000X	Emergency Medicine Physician	241771	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821125899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY ANNE DEMARTINO MD

Provider Business Mailing Address
First Line	:	9 AMBERWOOD DR
Second Line	:
City	:	EXETER
State	:	NH
Zip	:	03833-4723
Country	:	US
Telephone Number	:	518-577-9669
Fax Number	:	603-580-7006

Provider Business Practice Location Address
First Line	:	17 BELMONT AVE STE 1
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-3498
Country	:	US
Telephone Number	:	180-225-7820
Fax Number	:	802-257-8834

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/27/2022

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Directions to “ WENDY ANNE DEMARTINO MD” Practice Location

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