Healthcare Provider Details

I. General information

NPI: 1003324708
Provider Name (Legal Business Name): WOLF VERDINER PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WOLF VERDINER PSYCHIATRIC NP

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MADISON AVE
HEMPSTEAD NY
11550-4811
US

IV. Provider business mailing address

15 MADISON AVE
HEMPSTEAD NY
11550-4811
US

V. Phone/Fax

Practice location:
  • Phone: 516-566-3629
  • Fax:
Mailing address:
  • Phone: 516-566-3629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405942-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: