Healthcare Provider Details

I. General information

NPI: 1720997000
Provider Name (Legal Business Name): RANDOLPH SCOTT WOLFE OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W BROAD ST STE 100
BETHLEHEM PA
18018-5229
US

IV. Provider business mailing address

3040 COPLAY LN
WHITEHALL PA
18052-3430
US

V. Phone/Fax

Practice location:
  • Phone: 610-866-5600
  • Fax: 610-866-6451
Mailing address:
  • Phone: 484-619-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOC003219L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: