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General NPI Number Information
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NPI Number | 1790957843
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Entity Type | Organization
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Legal Business Name | DAVID J WOLF M.D., PC
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 01/26/2009
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Provider Practice Location Address
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Address Line | 115 E 61ST ST 11TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065-8183
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Country | US
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Telephone | 212-688-7100
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Fax | 212-308-5242
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Provider Business Mailing Address
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Address Line | 115 E 61ST ST 11TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10065-8183
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Country | US
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Telephone | 212-688-7100
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Fax | 212-308-5242
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Authorized Official
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Title or Position | BILLING
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Name | ALLA GUZ
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Credential |
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Telephone | 212-688-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 121007
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License Number State | NY
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