Healthcare Provider Details

I. General information

NPI: 1811904758
Provider Name (Legal Business Name): STEVEN WOLFSON MS LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 ROUTE 9 SOUTH #8
MANALAPAN NJ
07726
US

IV. Provider business mailing address

PO BOX 140125
BROOKLYN NY
11214
US

V. Phone/Fax

Practice location:
  • Phone: 732-845-2200
  • Fax: 732-845-0154
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00037100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number26NR12516600
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number569098
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: