1013036581 NPI number — DR. WENDY ANNE HARRIS M.D.

Table of content: DR. ALISSA S REXO (NPI 1972132090)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013036581 NPI number — DR. WENDY ANNE HARRIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
WENDY
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARRIS-HEALY
Provider Other First Name:
WENDY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013036581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 416
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CUMBERLAND
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04021-0416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-219-5524
Provider Business Mailing Address Fax Number:
914-219-5754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE HUNTER AVENUE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ARMONK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-219-5524
Provider Business Practice Location Address Fax Number:
914-219-5754
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  033874 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 203276 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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