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General NPI Number Information
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NPI Number | 1407931868
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Entity Type | Individual
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Provider Name | NORBERT S WOLLOCH MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | MMG - CROSS COUNTY 1010 CENTRAL PARK AVENUE
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City | YONKERS
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State | NY
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Zip | 10704
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Country | US
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Telephone | 914-964-4000
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Fax | 914-964-4050
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Provider Business Mailing Address
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Address Line | 1010 CENTRAL PARK AVE
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City | YONKERS
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State | NY
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Zip | 10704-1044
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Country | US
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Telephone | 914-964-4000
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Fax | 914-964-4050
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 151532
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License Number State | NY
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