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NPI Code Detail

MEDICARE: DR. GABRIELLE J WOLFSBERGER MD

MEDICARE: DR. GABRIELLE J WOLFSBERGER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician142963NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124067988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GABRIELLE J WOLFSBERGER MD
Provider Business Mailing Address
First Line : 4068 ALBANY POST RD
Second Line : STE 4S
City : HYDE PARK
State : NY
Zip : 12538-3900
Country : US
Telephone Number : 845-229-2123
Fax Number :
Provider Business Practice Location Address
First Line : 4068 ALBANY POST RD
Second Line :
City : HYDE PARK
State : NY
Zip : 12538-3900
Country : US
Telephone Number : 845-229-2123
Fax Number : 845-452-2156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 11/19/2012

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