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General NPI Number Information
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NPI Number | 1831728674
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Entity Type | Individual
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Provider Name | THIJS ALEXANDER WOLF DO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-463-2940
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Fax | 585-473-3516
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Provider Business Mailing Address
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Address Line | 45 EDENDERY CIR
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City | FAIRPORT
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State | NY
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Zip | 14450-1013
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Country | US
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Telephone | 814-636-2734
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 321852
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License Number State | NY
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