Individual ProviderWendy V FredericksRegistered NurseNursing Service ProvidersPractice Address22020 Stronghurst Ave Unit 1914, Queens Village, NY 11427-2007(718) 928-5638PECOS EnrollmentBased on the most recent information from CMS, provider Wendy V Fredericks does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1497314629Provider TypeIndividualFull NameFredericks, Wendy VCredentialRNGenderFemaleSole ProprietorYesEnumeration Date6/11/2019Last Updated6/11/2019Contact InformationPractice LocationPractice Address22020 Stronghurst Ave Unit 1914, Queens Village, NY 11427-2007Phone(718) 928-5638FaxUnlisted FaxMailing LocationMailing Address22020 Stronghurst Ave Unit 1914, Queens Village, NY 11427-2007Phone(718) 928-5638FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense517067-1New York