Healthcare Provider Details

I. General information

NPI: 1659466266
Provider Name (Legal Business Name): ALEXANDER WOLFSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 WITHERSPOON ST
PRINCETON NJ
08540-3211
US

IV. Provider business mailing address

56 WESTBURY CT
SKILLMAN NJ
08558-1726
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-4000
  • Fax:
Mailing address:
  • Phone: 917-447-0568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number229420
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD63717
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA08370700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: