Healthcare Provider Details

I. General information

NPI: 1750381984
Provider Name (Legal Business Name): ELIZABETH A WOLFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 W HARRISBURG PIKE
MIDDLETOWN PA
17057-4848
US

IV. Provider business mailing address

307 S FRONT ST 1ST FLOOR
HARRISBURG PA
17104-1621
US

V. Phone/Fax

Practice location:
  • Phone: 717-944-0491
  • Fax: 717-944-1436
Mailing address:
  • Phone: 717-231-8540
  • Fax: 717-231-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number211874
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD449428
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: