Healthcare Provider Details

I. General information

NPI: 1578883559
Provider Name (Legal Business Name): GILLIAN WOLFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARY IMOGENE BASSETT HOSPITAL 1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

IV. Provider business mailing address

MARY IMOGENE BASSETT HOSPITAL 1 ATWELL RD
COOPERSTOWN NY
13326-1301
US

V. Phone/Fax

Practice location:
  • Phone: 607-547-3400
  • Fax:
Mailing address:
  • Phone: 607-547-3480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD.207964
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License NumberMD.207964
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number289210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: