Healthcare Provider Details

I. General information

NPI: 1154813830
Provider Name (Legal Business Name): REBECA WOLF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 VALLEY HEALTH PLZ
PARAMUS NJ
07652-3619
US

IV. Provider business mailing address

159 E ALLENDALE RD
SADDLE RIVER NJ
07458-2703
US

V. Phone/Fax

Practice location:
  • Phone: 201-447-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25MB11168800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: