Provider Demographics
NPI:1215053186
Name:FROST, WENDY (NP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5302
Mailing Address - Country:US
Mailing Address - Phone:516-482-4343
Mailing Address - Fax:516-482-0112
Practice Address - Street 1:900 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5302
Practice Address - Country:US
Practice Address - Phone:516-482-4343
Practice Address - Fax:516-482-0112
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF360322363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology