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General NPI Number Information
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NPI Number | 1912816695
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Entity Type | Individual
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Provider Name | MATTHEW WOLF PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 115 EILEEN WAY
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City | SYOSSET
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State | NY
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Zip | 11791-5323
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Country | US
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Telephone | 516-622-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 27 SABER DR
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City | KINGS PARK
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State | NY
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Zip | 11754-2833
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Country | US
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Telephone | 516-622-9797
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 056422
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License Number State | NY
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