Provider Demographics
NPI:1528061983
Name:ANGELO, WENDY A (MD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:A
Last Name:ANGELO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5036
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10602-5036
Mailing Address - Country:US
Mailing Address - Phone:845-745-3611
Mailing Address - Fax:
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2913
Practice Address - Country:US
Practice Address - Phone:914-734-8800
Practice Address - Fax:845-765-9406
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48304207Q00000X
NH10892207Q00000X
PAMD056517L207Q00000X
NY335159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01YP02430NH01OtherANETHEM ID#
NH080186867OtherRAILROAD MEDICARE ID
NH3017025OtherAETNA ID#
PAP023475OtherGATEWAY
PA12561940OtherMULTIPLAN
NH222594672OtherUNITED HEALTHCARE ID
NH222594672OtherTRICARE ID
PA2248512OtherUNITED HEALTHCARE
NH30200740Medicaid
PAQZZ000000208841OtherAETNA BETTER HEALTH
NH222594672OtherHEALTHCARE VALUE MANAGE#
NH35973OtherCIGNA ID#
PA888567OtherUPMC
NH713530OtherHARVARD PILGRIM ID#
PA7599428OtherAETNA
PA2547667OtherCIGNA
NH222594672OtherGREATWEST HEALTHCARE
PA003607668OtherHIGHMARK
PA103284080Medicaid
PA30703781OtherAMERIHEALTH CARITAS & VIP
NH371509OtherMVP ID#
PA578117NWBOtherMEDICARE
NH222594672OtherPRIVATE HEALTHCARE ID