Healthcare Provider Details

I. General information

NPI: 1457263493
Provider Name (Legal Business Name): SHMUEL WOLFF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14466 SUMMERFIELD RD
UNIVERSITY HEIGHTS OH
44118-4637
US

IV. Provider business mailing address

14466 SUMMERFIELD RD
UNIVERSITY HEIGHTS OH
44118-4637
US

V. Phone/Fax

Practice location:
  • Phone: 323-629-6011
  • Fax:
Mailing address:
  • Phone: 323-629-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0043421
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: