Wainwright Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

234018 Issued in NY

Legal business name

WAINWRIGHT DERMATOLOGY, PLLC

Practice address

19 North Salem Road
2ND Floor
Cross River, NY 10518-0365

Phone

(914) 763-3000

Fax

(718) 518-8616

NPI assigned

Jul 12, 2007

Last updated

Jan 23, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brent Wainwright, MD

Title

Pricipal Physician - One Member LLC

Phone

(914) 763-3000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Bourke, RPA-C

  • Medical Physician Assistant
  • Londonderry, NH
  • NPI 1194070466
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1457550352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "CROSS RIVER",
            "state": "NY",
            "postal_code": "105180365",
            "telephone_number": "914-763-3000",
            "fax_number": "718-518-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 NORTH SALEM ROAD",
            "address_2": "2ND FLOOR",
            "city": "CROSS RIVER",
            "state": "NY",
            "postal_code": "105180365",
            "telephone_number": "914-763-3000",
            "fax_number": "718-518-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAINWRIGHT DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "WAINWRIGHT",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "PRICIPAL PHYSICIAN - ONE MEMBER LLC",
        "authorized_official_telephone_number": "914-763-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "234018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Marie Stumacher, LCSW
• Michael John Sweeney, DPT
• Therapeutic Acupuncture Wellness PLLC
• Tri County Promises Inc (Home Helpers & Direct Link 58879)
• Christian Tsakanikas, ATC
• Marc David Waldman, M.D.
• Rebecca Walkley, MS, LMHC
• Joan B Weiler, LCSW-R
• Dorothy J. Whalen, LCSW,RN, CASAC
• Jennifer White

• Dermatology Physician in Cross River, NY
• Providers in Cross River, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.