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General NPI Number Information
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NPI Number | 1588541122
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Entity Type | Individual
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Provider Name | MADISYN MACKENZY WOLFE PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 726 WICK AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-2827
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Country | US
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Telephone | 330-747-9551
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Fax |
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Provider Business Mailing Address
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Address Line | 6561 DUCK CREEK RD
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City | BERLIN CENTER
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State | OH
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Zip | 44401-9655
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Country | US
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Telephone | 814-715-6149
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.009606RX
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License Number State | OH
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