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General NPI Number Information
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NPI Number | 1043630510
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Entity Type | Individual
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Provider Name | RYAN WOLFE DO
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Gender | Male
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 170 CAREY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-7830
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Country | US
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Telephone | 518-793-1000
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Fax | 518-761-4674
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Provider Business Mailing Address
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Address Line | PO BOX 985
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City | GLENS FALLS
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State | NY
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Zip | 12801-0985
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Country | US
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Telephone | 518-793-1000
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Fax | 518-761-4674
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 310343
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 032-0133898
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License Number State | VT
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