Provider Demographics
NPI:1841463791
Name:DR WENDY BIAGIOTTI PHYSICIAN P.C.
Entity type:Organization
Organization Name:DR WENDY BIAGIOTTI PHYSICIAN P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIAGIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-863-7925
Mailing Address - Street 1:PO BOX 4389
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-9998
Mailing Address - Country:US
Mailing Address - Phone:718-863-7925
Mailing Address - Fax:718-863-8208
Practice Address - Street 1:3101 EAST TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5705
Practice Address - Country:US
Practice Address - Phone:718-863-7925
Practice Address - Fax:718-863-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY197454OtherLICENSE
NY197454OtherLICENSE