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General NPI Number Information
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NPI Number | 1558877837
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Entity Type | Individual
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Provider Name | ANDREW J WOLFANGER
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Gender | Male
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 235 W 75TH ST
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City | NEW YORK
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State | NY
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Zip | 10023-8220
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Country | US
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Telephone | 646-518-5559
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Fax | 212-400-4247
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Provider Business Mailing Address
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Address Line | 307 5TH AVE FL 6
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City | NEW YORK
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State | NY
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Zip | 10016-6575
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Country | US
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Telephone | 212-759-2282
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Fax | 212-379-2123
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 042549
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License Number State | NY
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