Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 007876 | NY |
NPI | 1053407932 |
---|---|
Provider Name | Mrs. Wendy C Essenburg |
First Address | Selden, NY 11784 |
Second Address | Selden, NY 11784 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |