Provider Demographics
NPI:1215337027
Name:BROWN-MAGETT, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:BROWN-MAGETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 ARLINGTON AVE
Mailing Address - Street 2:BRONX
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1402
Mailing Address - Country:US
Mailing Address - Phone:212-470-6557
Mailing Address - Fax:347-326-7430
Practice Address - Street 1:5800 ARLINGTON AVE
Practice Address - Street 2:BRONX
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1402
Practice Address - Country:US
Practice Address - Phone:212-470-6557
Practice Address - Fax:347-326-7430
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY171M00000XOtherCASE MANAGER/CARE COORDINATOR