Provider Demographics
NPI:1285440677
Name:ATROR, WENDY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:ATROR
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 1:908 AFTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-3208
Mailing Address - Country:US
Mailing Address - Phone:267-428-9371
Mailing Address - Fax:
Practice Address - Street 1:16 OLD ASHTON RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-1661
Practice Address - Country:US
Practice Address - Phone:215-613-5069
Practice Address - Fax:215-613-6809
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily