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General NPI Number Information
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NPI Number | 1124053640
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Entity Type | Organization
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Legal Business Name | CENTEROCK PODIATRY ASSOCIATES, PC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 2 CROSFIELD AVE SUITE 302
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City | WEST NYACK
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State | NY
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Zip | 10994-2226
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Country | US
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Telephone | 845-358-2844
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Fax | 845-358-0528
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Provider Business Mailing Address
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Address Line | 2 CROSFIELD AVE SUITE 302
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City | WEST NYACK
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State | NY
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Zip | 10994-2226
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Country | US
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Telephone | 845-358-2844
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Fax | 845-358-0528
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES J WOLFF
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Credential | DPM
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Telephone | 845-358-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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