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General NPI Number Information
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NPI Number | 1396993473
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Entity Type | Individual
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Provider Name | WILLIAM A WOLKSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 24 BRANDON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1330
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Country | US
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Telephone | 973-885-4805
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Fax | 973-992-0676
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Provider Business Mailing Address
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Address Line | 24 BRANDON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1330
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Country | US
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Telephone | 973-885-4805
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Fax | 973-992-0676
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 40796
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License Number State | NJ
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